University of Manitoba, Winnipeg, MB, Canada.
University of New Brunswick Saint John, Saint John, NB, Canada.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211046436. doi: 10.1177/21501327211046436.
Community health centers (CHCs) have been used for delivery of health services since the 1920s and originally were intended to provide care to underserved populations. CHCs have become an integral part of healthcare systems in many countries; however, the term CHC is used synonymously with other concepts and there is no clear definition for CHC. The purpose of our concept analysis was to determine how CHCs are described in the literature and to develop a concept definition for CHC. Informed by the 8-step process described by Walker and Avant, we searched for literature spanning disciplines within health, business, and policy. We used a systematic review process to identify a range of peer-reviewed articles that help illustrate the attributes, antecedents, and consequences of CHCs. A total of 102 articles from 7 databases were included in our concept analysis. We distinguished 6 attributes of a CHC: primary care; accessibility; preventative care; defined population; health promotion; and comprehensive and integrated care. About 4 antecedents fundamental to a CHC included: secure funding; vision and support; adequate human resources; and governance structure. Consequences of CHCs are improved health outcomes, efficiency, and cost-effective provision of healthcare services. Our concept analysis revealed core characteristics of CHCs that assisted us in synthesizing a concept definition for CHC. These characteristics and our proposed definition will help provide clarity on the concept of CHC to benefit evaluation, research, and policy development of CHCs.
社区卫生中心(CHC)自 20 世纪 20 年代以来一直被用于提供卫生服务,其最初的目的是为服务不足的人群提供医疗服务。CHC 已经成为许多国家医疗保健系统的不可或缺的一部分;然而,CHC 这一术语与其他概念同义使用,且没有对 CHC 的明确定义。我们的概念分析旨在确定文献中如何描述 CHC,并为 CHC 制定一个概念定义。我们根据 Walker 和 Avant 描述的 8 个步骤,在健康、商业和政策等学科领域内搜索文献。我们使用系统的审查过程来确定一系列有助于说明 CHC 属性、前因和后果的同行评审文章。我们的概念分析共纳入了来自 7 个数据库的 102 篇文章。我们区分了 CHC 的 6 个属性:初级保健;可及性;预防保健;特定人群;健康促进;以及全面和综合的医疗服务。CHC 的约 4 个基本前提包括:有保障的资金;愿景和支持;充足的人力资源;以及治理结构。CHC 的后果是改善健康结果、提高效率和提供具有成本效益的医疗服务。我们的概念分析揭示了 CHC 的核心特征,帮助我们综合了 CHC 的概念定义。这些特征和我们提出的定义将有助于澄清 CHC 的概念,从而有利于 CHC 的评估、研究和政策制定。