Aday L A, Andersen R, Loevy S S, Kremer B
Am J Public Health. 1984 Aug;74(8):792-8. doi: 10.2105/ajph.74.8.792.
This article, the second of two, considers the impact of a nationwide demonstration of 53 community hospital sponsored group practices (CHPs). Surveys of a sample of the communities in which the CHPs were introduced suggest that about half of the communities were socioeconomically and, to some extent, medically disadvantaged. The CHPs tended to attract people who had previously not had a regular source of care or who used hospital outpatient departments or emergency rooms, as well as patients of established primary care physicians. Access to care and satisfaction appeared to be as good or better for CHP patients compared to regular patients of physicians in the target areas. The programs did not increase the use of inpatient services, emergency rooms, or hospital outpatient departments. The findings suggest that at present community hospital sponsored group practices would not have a profound effect on access to care if adopted nationally, but that targeted implementation by hospitals in lower income and minority communities can improve patient opportunities for appropriate primary care services.
本文是系列文章中的第二篇，探讨了由53家社区医院发起的团体医疗实践在全国范围内的示范效果。对引入团体医疗实践的部分社区进行的调查显示，约一半的社区在社会经济方面以及在一定程度上在医疗方面处于劣势。团体医疗实践往往吸引那些以前没有固定医疗服务来源、或使用医院门诊部或急诊室的人，以及现有初级保健医生的患者。与目标地区医生的常规患者相比，团体医疗实践的患者获得医疗服务的机会和满意度似乎相同或更高。这些项目并未增加住院服务、急诊室或医院门诊部的使用量。研究结果表明，目前社区医院发起的团体医疗实践如果在全国范围内采用，对获得医疗服务的机会不会产生深远影响，但低收入和少数族裔社区的医院有针对性地实施可以改善患者获得适当初级保健服务的机会。
