Primary care as part of US health services reform

Article Abstract:

Creation of a health care system that is based on primary care is needed to achieve true reform in health services. Poor primary care underlies or aggravates the other problems facing the US health care system - ensuring access, maintaining quality and controlling costs. Primary care-oriented systems are more cost-efficient and are associated with lower death rates and higher patient satisfaction. The four main goals in creating a primary care infrastructure are to encourage the use of primary care physicians instead of specialists, increase the number of primary care physicians and increase the attractiveness and intellectual challenge of practicing primary care. To achieve these goals, policy-makers should promote the use of primary care through reimbursement mechanisms, establish a more rational referral policy, restructure licensing laws and regulations, provide financial incentives for studying and practicing primary care and increase funding for primary care research.

Planning, Family medicine, Health care reform

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Quality-of-Care Research

Article Abstract:

Much of the research on the quality of medical care must be improved before any conclusions can be made about how good-quality care can be delivered. In 1998, the National Roundtable on Health Care Quality of the Institute of Medicine concluded that the US needs to improve health care quality. The advent of evidence-based medicine means that most clinical decisions will be based on the results of clinical trials. However, these trials often focus on hospital patients and the elderly or on very select populations. The results of the trial may not be applicable to other age groups.

Evaluation, Clinical trials, Quality management, Medical care quality

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Access - perceived or real, and to what?

Article Abstract:

Better perceived access to health care and ambulatory care appears to reduce hospitalization rates. Studies show that people who have a consistent single physician in charge of their care have lower rates of hospitalization. Furthermore, hospitalization rates for conditions that can be prevented by good ambulatory care are much lower in areas with higher ratios of primary care physicians to the population. Primary care may be an important factor in producing good health care results at lower costs.

Health aspects, Editorial, Hospitalization, Hospital care

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