Application of epidemiology in community oriented primary care.

Community oriented primary care (COPC) is the integrated practice of primary health care and community medicine, bringing together the care of individuals and the care of the community and its subgroups. Epidemiology plays an indispensable role in COPC. The specific features of epidemiology as it is applied in COPC include its pragmatic purpose, its locale, its content, its scale, its specific relevance to the community health programs of the practice, and its clinical setting. The functions of epidemiology in the phases of program development are in the appraisal of needs and priorities, in community diagnosis and health surveillance, in the formulation of objectives and targets, in the choice of strategies and the identification of target groups, and in the implementation, monitoring, and evaluation of programs--as well as in the stimulation of community involvement and as an aid to the clinical management of individual patients. Teaching the epidemiologic skills that are required for COPC necessitates exposure to an epidemiology curriculum which deals with these features and to a COPC practice. An urgent need exists to develop units that will practice, teach, and demonstrate COPC--units in which practitioners, teachers, and students can gain experience and develop, test, and evaluate approaches to the provision of COPC.