Mettee T M, Martin K B, Williams R L
Chesterland Family Practice, Ohio, USA.
J Am Board Fam Pract. 1998 Jan-Feb;11(1):28-33. doi: 10.3122/15572625-11-1-28.
Community-oriented primary care (COPC) is an increasingly attractive paradigm for primary care delivery. Further work is needed, however, to implement COPC in busy practice settings. This study reports a feasible method for linking practice and community health data for use in COPC.
Using one practice and its community as an example of the process, we sought data related to five common cancers. Data from readily accessible community sources were combined with practice morbidity data using commonly available computer hardware and software.
We developed a user-friendly database and maps showing rates and distribution of the example diseases. We also developed strategies to obtain complete case identification and to address confidentiality and proprietary concerns.
Understanding patterns of disease expression in the practice and the community is critical to the COPC process. Rapid, inexpensive methods for displaying these patterns, such as the database and maps described, must be accessible to clinicians if COPC is to move from theory into practice. Partnerships between health care providers and institutions can also help get this capability into the hands of clinicians.
以社区为导向的初级保健（COPC）是一种越来越有吸引力的初级保健提供模式。然而，在繁忙的医疗实践环境中实施COPC还需要进一步的工作。本研究报告了一种将医疗实践和社区健康数据相联系以供COPC使用的可行方法。
以一个医疗实践及其所在社区为例，介绍该过程，我们收集了与五种常见癌症相关的数据。利用常用的计算机硬件和软件，将来自易于获取的社区来源的数据与医疗实践中的发病率数据相结合。
我们开发了一个用户友好的数据库和地图，展示了示例疾病的发病率和分布情况。我们还制定了获取完整病例识别信息以及解决保密性和所有权问题的策略。
了解疾病在医疗实践和社区中的表现模式对于COPC过程至关重要。如果COPC要从理论走向实践，临床医生必须能够使用快速、廉价的方法来展示这些模式，如本文所述的数据库和地图。医疗保健提供者与机构之间的合作关系也有助于临床医生掌握这种能力。
