Appendix

Characteristics of Primary Care Described in the First IOM Report (IOM 1978)

  1. Accessibility of services includes availability (e.g., round-the-clock coverage, response to requests for urgent care) and attainability (e.g., physical, economic, psychological, and social aspects of services).

  1. Comprehensiveness of services reflects the willingness and ability to handle the great majority of problems in the population served, including adults and children. It entails

    • Preventive services,

    • Care in a variety of settings (e.g., hospital, chronic care unit, or home),

    • Differentiation of primary care from specialty care, and

    • Differentiation of primary care from care provided by other professionals (e.g., optometrists, podiatrists, and dentists).

  1. Coordination of services involves

    • Care given by other clinicians including specialists, and

    • The inclusion of patients and their families in decisions regarding plans of care, financial capabilities, and personal desires.

  1. Continuity of services (a characteristic that cannot exist without the first three attributes listed above) involves record continuity and provider continuity.



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OCR for page 41
Defining Primary Care:: An Interim Report Appendix Characteristics of Primary Care Described in the First IOM Report (IOM 1978) Accessibility of services includes availability (e.g., round-the-clock coverage, response to requests for urgent care) and attainability (e.g., physical, economic, psychological, and social aspects of services). Comprehensiveness of services reflects the willingness and ability to handle the great majority of problems in the population served, including adults and children. It entails Preventive services, Care in a variety of settings (e.g., hospital, chronic care unit, or home), Differentiation of primary care from specialty care, and Differentiation of primary care from care provided by other professionals (e.g., optometrists, podiatrists, and dentists). Coordination of services involves Care given by other clinicians including specialists, and The inclusion of patients and their families in decisions regarding plans of care, financial capabilities, and personal desires. Continuity of services (a characteristic that cannot exist without the first three attributes listed above) involves record continuity and provider continuity.

OCR for page 41
Defining Primary Care:: An Interim Report Accountability (described by that committee as an essential characteristic that is not unique to primary care) includes Process and outcome measurement, Providing information to allow informed decisionmaking, and Financial accountability (e.g., maintaining adequate professional liability coverage).