Show For example the homeless migrant farmworkers and their families Medicaid population or an HMOmembership could be so defined Itis helpful to focus on those individuals incommunity who are not receiving primary health care services These individuals are often outside of the health care system Itis important to the impact on health in the community if this population segment includes pregnant teenagers unimmunized untreated with individuals children hepatits g diseases infectious tuberculosis HIV or undiagnosed and asymptomatic hypertensives and diabetics The other critical aspect of the community is its involvement in determining and addressing health care needs Little can be accomplished incommunity whose priorities are at odds with those of the health care provider Equally important primary care practice is missingvaluable source of information about unmet health needs in its community if there is no interaction and involvement with the community The scope of this article does not permitmore detailed discussion about community empowerment and involvement both of which lead tobetter understanding ofcommunityhealth needs and more effective interventions ofpreventive and or therapeutic nature The COPC Process Itis helpful to think of the COPC process in five steps community Determining our Characterizing our community in terms of its health status Prioritizing the health needs of our community Developing specific interventions to address priority needs and Evaluating the effectiveness of the lerventions StepWho is our Community The provider is encouraged to ask these questions who does my practice serve who could my practice serve and who should my practice serve This can be easy inrural practice because the geographic boundaries are often quite clear The questions are equally important for urban providers albeit more challenging to answer Providers can map the zip codes of their current patients to gainbetter understanding of the area they actually serve The point of this step is to identify the population group that the provider hopes to positively impact including those critical individuals who are currently outside of the communityhealth care system Though not homogeneous rural Utah is thought to be more readily divided into some geographic entities with some recognized boundaries ity ng Commun iziracterour Cha Step This is the data-gathering step which may ocur over many weeks and becomes an ongoing part of the practice The primary care practice in partnership with community members needs to identify the multitude of health problems affecting the community We recommend that these health problems be organized according to key age groups within the population For example theS Public Health Service programs which serve medically undeserved populations gather information for five groups pediatric adolescent adult geriatric and perinatal There are many Utah sources of quantitative data available including vital statistics derived from birth and death certificates hospital admission and discharge data emergency room utilization police reports g substance abuse domestic abuse W and health department reports both local and state There are alsonumber of national data sources These sources can be extrapolated to smaller areas including those from the National Center for Health Statistics and the Centers for Disease Control and Prevention Finally we must emphasize the importance of qualitative data derived from the community through techniques such as patient surveys focus groups and key informant surveys of individuals from relevant organizations StepPrior ing Important Health Problems For each age group the listing of the health problems identified needs to be prioritized in order of importance This iscritical point for community input The provider needs to understand the communityperspective on Frommedical health problems standpoint we often view importance by the volume of the problem the impact the problem has on the community whether 14 Digital image 2005 Marriott Library University of Utah Al rights reserved |