Epstein C J, Erickson R P, Hall B D, Golbus M S
Department of Pediatrics, University of California, San Francisco 94143.
Am J Hum Genet. 1975 May;27(3):322-32.
A 6-year experience with a center-satellite system for the provision of comprehensive genetic counseling services to a large geographical area is described. A series of 12 satellite genetic clinics established throughout northern and central California have brought genetic counseling services to within a 2-hour drive for most patients. These satellite clinics are largely organized by local groups (such as National Foundation-March of Dimes chapters and county health departments) but are backed by the personnel and resources of the center at the University of California, San Francisco. Assistance is generally provided by county public health nurses who collect medical records from referring physicians and pedigrees from the family. Specimens for cytogenetic or special biochemical studies are brought back to the center, but, if possible, other laboratory determinations, radiological investigations, and specialty consultations are obtained locally. Follow-up counseling may be provided by the public health nurses, and a written summary is sent to each patient or family. The socioeconomic spectrum of the patients seen at the satellite clinics is much broader than at the central clinic, and the establishment of a satellite clinic results in a great increase in the number of cases seen from the area in which it is located. Physician time per patient and cost of services per patient are substantially the same in both central and satellite clinics. Based on population figures applicable to the state of California, it is estimated that approximately 60-70 comprehensive counseling centers, each with up to 15 satellites, could adequately provide for the foreseeable genetic counseling needs of the United States.
本文描述了一个中心 - 卫星系统在为广大地理区域提供全面遗传咨询服务方面的六年经验。在加利福尼亚州北部和中部各地设立了一系列12个卫星遗传诊所，使大多数患者在两小时车程内就能获得遗传咨询服务。这些卫星诊所主要由当地团体（如美国国家早产基金会分会和县级卫生部门）组织，但由加利福尼亚大学旧金山分校中心的人员和资源提供支持。通常由县公共卫生护士提供协助，他们从转诊医生那里收集病历，并从家庭中收集系谱。细胞遗传学或特殊生化研究的标本被带回中心，但如果可能的话，其他实验室检测、放射学检查和专科会诊在当地进行。公共卫生护士可能会提供后续咨询，并向每位患者或家庭发送书面总结。卫星诊所接待的患者社会经济范围比中心诊所广泛得多，卫星诊所的设立使所在地区就诊的病例数量大幅增加。中心诊所和卫星诊所每位患者的医生诊疗时间和服务成本基本相同。根据适用于加利福尼亚州的人口数据估计，大约60 - 70个综合咨询中心，每个中心最多配备15个卫星诊所，就可以充分满足美国可预见的遗传咨询需求。
