Nutting P A, Wood M, Conner E M
JAMA. 1985;253(12):1763-6.
Community-oriented primary care (COPC) is a variation on the primary care model, which is characterized by the complementary use of epidemiologic and primary care skills to systematically address the health care needs of a defined population. A study by the Institute of Medicine developed an operational model of COPC and examined its feasibility under differing organizational and financial arrangements. Although COPC is usually associated with publicly funded programs for underserved populations, the study demonstrated its presence in the private sector as well. However, the financial structure of the practice remains a critical factor determining the particular expression of the model. The study points to the need for data describing the marginal cost and health impact of COPC, if this promising innovation is to become an important form of primary care practice.
以社区为导向的初级保健(COPC)是初级保健模式的一种变体,其特点是综合运用流行病学和初级保健技能,系统地满足特定人群的医疗保健需求。医学研究所的一项研究制定了COPC的运作模式,并研究了其在不同组织和财务安排下的可行性。虽然COPC通常与针对服务不足人群的公共资助项目相关联,但该研究表明它在私营部门也存在。然而,实践的财务结构仍然是决定该模式具体表现形式的关键因素。该研究指出,如果这种有前景的创新要成为初级保健实践的一种重要形式,就需要有关COPC边际成本和健康影响的数据。