Weiner J P, Starfield B H
Am J Public Health. 1983 Jun;73(6):666-71. doi: 10.2105/ajph.73.6.666.
The Baltimore City Primary Care Study examined the role of the urban office-based physician in the delivery of primary care. During the course of the study, questionnaires were completed by over 90 per cent of licensed physicians in the city, and data were collected from a sample of 16,000 patients. The study developed and assessed three approaches for the measurement of primary care. An empirical method was based upon information regarding the following characteristics of each visit: first contact visit, referral visit, specialized care visit, or principal care visit. A normative method was based on an assessment of the degree to which the practice provided care that was comprehensive, longitudinal, accessible, and family-centered. The third method used physicians' judgments as to the proportion of patients for whom they maintained ongoing responsibility for general medical care. All three methods produced the same categorization of different specialties as providing either primary, intermediate, or specialty care. As a group, primary care physicians included general and family physicians, pediatricians, and general internists. General surgeons and obstetrician/gynecologists have characteristics of both primary care and specialist care. All other physician groups have characteristics of specialists. Any of these methods or a combination of methods can be used to assess the extent to which the practice of a particular physician or group of physicians provides primary care.
巴尔的摩市初级保健研究考察了城市诊所医生在提供初级保健方面的作用。在研究过程中，该市90%以上的执业医生完成了问卷调查，并从16000名患者样本中收集了数据。该研究开发并评估了三种衡量初级保健的方法。一种实证方法基于每次就诊的以下特征信息：首次就诊、转诊就诊、专科护理就诊或主要护理就诊。一种规范方法基于对该医疗机构提供全面、长期、可及且以家庭为中心的护理程度的评估。第三种方法使用医生对他们持续负责一般医疗护理的患者比例的判断。所有这三种方法对不同专科的分类相同，即分为提供初级、中级或专科护理。作为一个群体，初级保健医生包括普通科和家庭医生、儿科医生以及普通内科医生。普通外科医生和妇产科医生兼具初级保健和专科护理的特点。所有其他医生群体都具有专科医生的特点。这些方法中的任何一种或多种方法的组合都可用于评估特定医生或医生群体的执业提供初级保健的程度。
