Komaroff A L, Duffell P J
Am J Public Health. 1976 Mar;66(3):255-61. doi: 10.2105/ajph.66.3.255.
We examine evidence regarding the impact of several categorical federal health service programs--neighborhood health centers, maternal and infant care projects, and children and youth projects--on access to and quality of health care for the poor. We conclude that, although conclusive evidence of improved access and quality are lacking, suggestive evidence of improved quality exists. It is difficult to utilize legislative objectives as guidelines for evaluating the success of a federal program; it is also difficult to obtain solid data supporting the effectiveness or ineffectiveness of health care in general, and of other government programs. These difficulties are discussed.
我们研究了关于几个分类联邦医疗服务项目——社区健康中心、母婴护理项目以及儿童与青少年项目——对穷人获得医疗服务的机会和医疗质量影响的证据。我们得出结论,尽管缺乏关于改善获得医疗服务机会和质量的确凿证据,但存在质量有所改善的暗示性证据。将立法目标用作评估联邦项目成功与否的指导方针很困难;同样难以获得确凿数据来支持总体医疗保健以及其他政府项目的有效性或无效性。本文讨论了这些困难。