Reynolds R A
Milbank Mem Fund Q Health Soc. 1976 Winter;54(1):47-82.
Utilization, cost, and productivity patterns at neighborhood health centers (NHCs) are examined on the basis of data from 82 centers. Minority groups and residents of the South and rural areas are found to have achieved levels of care and benefits closer to equality with other groups at NHCs than has been their health care experience generally. Continuity and comprehensiveness of care and the use of paramedical personnel are shown to be important contributory factors to utilization of NHCs. The impact of alternative cost-saving devices at NHCs is considered. It appears unlikely that professional productivity can be markedly improved. Increasing third-party payments is the most likely means of reducing dependence on operating grants without deleterious effects on utilization. The problem NHCs have had in maintaining stable professional staffs is shown to be a problem which needs further attention if the program is to expand.
基于82家社区卫生中心的数据，对其利用情况、成本和生产率模式进行了研究。研究发现，少数群体以及南部和农村地区的居民在社区卫生中心获得的医疗服务水平和福利，比他们总体上的医疗保健经历更接近与其他群体的平等水平。医疗服务的连续性和全面性以及辅助医疗人员的使用，被证明是社区卫生中心利用率的重要促成因素。考虑了社区卫生中心其他成本节约措施的影响。专业人员的生产率似乎不太可能得到显著提高。增加第三方支付是减少对运营补助的依赖且不对利用率产生有害影响的最有可能的手段。如果该项目要扩大，社区卫生中心在维持稳定专业人员方面存在的问题表明这是一个需要进一步关注的问题。
