| Show elements include public health principles primary care practice anddefined community This COPC paradigm offersway to include the disciplines of public health and preventive medicine with primary care practice inway that is understandable to the mainstream health care provider Each of these elements will be defined in greater detail followed bydiscussion of the five steps Concepts Public Health There are four main Public Health concepts that may be presented to the average health care provider in an easily understood fashion First is the concept of applied epidemiology Here the discussion is on the potential value of health data which has already been gathered particularly vital statistics for the provider practice For example the local obstetricians might benefit from knowing the teen pregnancy rate and the low birth weight rate for their community The pediatricians might benefit from knowing the leading causes of morbidity and mortality for young children in their county and the family physicians might utilize data on the leading causes of death of adolescents in their area Managed care organizations have long appreciated the value of data about their membership g reasons for emergency room utilization most frequent causes of hospitalizations and drug utilization patterns American Academy of Family Physicians 1991 Second is the concept of population-based health care The value ofdifferent approach to health care namely the care of population groups rather than individuals is introduced When teaching medical students Dr Marc Babitz uses the term room-to-room-to-room care asdescription of present medical practice and the way medical students are currently taught This is in contrast with the population-based perspective of public health practitioners Room-to-room-to-room care describes how providers currently work in their delivery of health care services Essentially provider goes to work expecting that the examination rooms will be filled with patients to be seen and when the exam rooms are empty the provider has completed the task The provider rarely if ever asks the following questions Why do certain patients actually get into the exam room while others do not access issue Are the patients being seen reflective of the health needs of the community at large needs assessment issue Are patients being left out of the current system of care with critical health care needs g children needing immunizations pregnant women needing prenatal care and untreated diabetics impact issue By asking these types of questions the provider is addingpopulation-based view of community health needs to their individual patient perspective McGinnis Foege 1993 Utah health professionals can easily apply this view for their community Third and fourth are the concepts of prevention and patient education in health care delivery valuable example to illustrate this item is to ask health care providers to think back over the past century and identify those advances in medicine which have contributed the most to improvement in the health status of Americans Even traditional providers are quick to recognize that sanitation adequate sewers and clean water supplies and immunizations have had far greater impact than the much more expensive interventions such as the use of the Magnetic Resonance Imager MRI Despite the rapidly rising costs of health care in this country there have been negligible improvements in overall health status as measured by longevity or infant mortality ascontrast to the tremendous advances achieved by two simple preventive interventions of the past Further the work of Drs McGinnis and Foege McGinnis Foege 1993 illustrates that the leading causes of death accounting for over 50 of deaths in the United States remain behavioral issues best approached through prevention and education Il Primary Care The definition of primary care practice is very important to the concept of COPC In this approach primary care is not defined as first-contact care nor is it defined based 12 Digital image 2005 Marriott Library University of Utah Al rights reserved |
