Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD 20857, USA.
Am J Public Health. 2012 Jun;102 Suppl 3(Suppl 3):S383-91. doi: 10.2105/AJPH.2012.300679.
We examined primary care and public health activities among federally funded health centers, to better understand their successes, the barriers encountered, and the lessons learned.
We used qualitative and quantitative methods to collect data from 9 health centers, stratified by administrative division, urban-rural location, and race/ethnicity of patients served. Descriptive data on patient and institutional characteristics came from the Uniform Data System, which collects data from all health centers annually. We administered questionnaires and conducted phone interviews with key informants.
Health centers performed well on primary care coordination and community orientation scales and reported conducting many essential public health activities. We identified specific needs for integrating primary care and public health: (1) more funding for collaborations and for addressing the social determinants of health, (2) strong leadership to champion collaborations, (3) trust building among partners, with shared missions and clear expectations of responsibilities, and (4) alignment and standardization of data collection, analysis, and exchange.
Lessons learned from health centers should inform strategies to better integrate public health with primary care.
我们研究了联邦资助的健康中心的初级保健和公共卫生活动，以更好地了解其成功之处、遇到的障碍和吸取的经验教训。
我们使用定性和定量方法从 9 家健康中心收集数据，这些健康中心按行政区域、城乡位置和服务对象的种族/族裔进行分层。来自统一数据系统的数据描述了患者和机构的特征，该系统每年从所有健康中心收集数据。我们向主要知情人发放了问卷并进行了电话访谈。
健康中心在初级保健协调和社区导向量表上表现良好，并报告开展了许多基本的公共卫生活动。我们确定了将初级保健和公共卫生整合的具体需求：（1）为合作以及解决健康的社会决定因素提供更多资金，（2）有强有力的领导力来支持合作，（3）在合作伙伴之间建立信任，共同的使命和明确的责任期望，以及（4）数据收集、分析和交流的统一和标准化。
从健康中心吸取的经验教训应该为更好地将公共卫生与初级保健相结合的策略提供信息。
