Community Oriented Primary Care A Practical Assessment, Vol. 1: Report of a Study (1984) / Chapter Skim
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Conclusions and Recommendations
Conclusions and Recommendations
Pages 97-106
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From page 97... ...
It is a Edification of Rark's model based on an understanding and appreciation of how primary care, commun ity or ientation , and epidemiologic investigation are likely to develop in the United States in the 1980s. The basic elements of the COPC model are: practice or service program active in primary care · defined community for which the practice has accepted responsibility for health care 97
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From page 98... ...
The 1982 Institute of Medicine conference identified, from among its parti- ~~ ~ ~~-~ - ~ the United States. Additional inquiries about the existence of other COPC-like practices were made of the conference participants, other persons in the federal government who are responsible for administering primary care progress and professional associations likely to have members engaged in primary cipants, 22 programs with COPC characteristics in
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From page 99... ...
However, they all were providing primary care services to a defined community and were engaged in some of the COPC functions to some extent. In the practices actively engaged in some elements of COPC their involvement tended to be with the early stages of identification and characterization of the community, the identification of the community's health problems, and the codification of the health care program in response to the community health need=.
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From page 100... ...
For the seven sites visited, examples of COPC functions being associated with positive effects on health were cited and, where available, internal practice data related to these examples were shared. For example, identifying a community health problem and modifying services in response to that problem was followed by a beneficial health outcome in the following instances: Screening for streptoccocal infection among school age children and high rick families was followed by a reduction in ache incidence of rheumatic fever at the Sells Service Unit.
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From page 101... ...
COPC is the clinical practice of primary care in a defined population coupled with systematic efforts to identify and address the major health problems of that popuration through effective smOificationn in both priory care services and other appropriate community heals programs. Combining these COPC functions with the practice of primary care is not a simple process and specific ways to accomplish this linkage have not been made e~licit.
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From page 102... ...
a variety As a result of this study the co~mnittee has concluded that the conceptual model of COPC promises to be nor e respons ive to the health needs of a population than current primary care practices and that the extent to which the application of this model will improve health is a question worth testing. To date this hypothesis has cone untested Decause no practice or group of practices has been able to put in place a fully developed model.
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From page 103... ...
Community Involvement An outstanding, relatively constant, and important feature of community medicine as it has been practiced in this country since the early 1960s has been the formal involvement of community members in the governance of the practice. The civil rights movement, the OEO community health centers, the philosophy and ethos of emerging departments of community medicine in academic medical centers in the 1960s -- all supported the involvement of patients and community members in the structure and management of c~o~unity-based health centers.
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From page 104... ...
COPC, in our judgment, represents a marital, evolutionary development in the provision of health care services in the United States. As this report documents, there
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From page 105... ...
In our judgment, these efforts are extremely important if the full benef its of COPC are to be realized. It will be the pragmatic, realworld, cost-sensitive, community-conscious practitioners and administrator s who will develop and adapt techniques of pr Wary care epidemiology, con munity assessment, practice modif ication and impact evaluation that will have a great deal to say about the v lability and importance of COPC as a pr inciple in health services delivery.
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From page 106... ...
Pp. 21-59 in Community Oriented Primary Care-New Directions for Health Services Delivery.
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