National Academies Press: OpenBook
« Previous: G Committee Biographies
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
This page in the original is blank.
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
This page in the original is blank.
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Index

A

Academic health centers, 188, 206, 207

interdisciplinary team training, 11

mission of, in primary care, 9, 24, 144, 257

role in primary care delivery, 111-112, 143-144, 173

Accessibility of services, 44, 47, 65-66, 240, 329

in primary care definition, 2, 31, 32, 33, 45-46

and workforce supply, 9, 20, 168, 169

Accountability

in clinician-patient partnership, 57-58

for efficient use of resources, 33, 49

for ethical behavior, 33, 49

for patient satisfaction, 33, 48-49

of patients, 49-50

in primary care definition, 2, 31, 33, 46-50

for quality of care, 33, 46-48, 242-243

research, 242-243

Accreditation organizations, 141, 193

and primary care curriculum, 10, 186, 194

Acute care, 40-41

Advanced care planning, 85

Advocacy skills, 192

African Americans, 157, 195

Agency for Health Care Policy and Research (AHCPR), 218, 220, 221, 223-224

All-payer system

for graduate medical education, 11, 202, 259

for primary care training, 6, 10, 201-202, 258-259

for research funding, 233

Alternative medicine, 126

American Academy of Family Physicians (AAFP), 190, 199

American Academy of Pediatrics, 199

American Board of Family Practice (ABFP), 208

American College of Obstetricians and Gynecologists (ACOG), 123, 190

American Society of Internal Medicine (ASIM), 122, 183

Asian Americans, 157, 195

Association of American Medical Colleges (AAMC), 182, 184

Availability of services, 8, 112-113, 253

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

B

Behavioral sciences, 81-82

Biomedical sciences, 3, 81, 191

Bureau of Health Professions (BHP), 198, 199, 220

C

CALPERS (California Public Employees Retirement System), 139

Capital markets, 22, 108

Capitation payments, 114-116

and mental health services, 115, 300-302

and withholding of services, 327

and workforce composition, 315

Caregivers, 35, 60

Catastrophic health insurance, 117

Centers for Disease Control and Prevention (CDC), 221

Certification and licensure, 10, 47

after physician retraining, 11, 210-211

examinations, 185

of nurse practitioners, 159-160, 316

Chronic care, 2, 18, 41, 67

Classification, see Diagnostic classification and coding

Clerkships, 182-184

Clinical decisionmaking, 3, 39, 83-84, 355

importance of continuity of care, 57

and mental disorders, 86-87, 288, 293-298, 299

by nonphysician clinicians, 320

patient participation, 85-86

theoretical bases, 81-83

Clinical nurse specialist (CNS) programs, 161-162

Clinical trials, 236-237 for mental health treatment, 287

Clinicians, 5, 148-149

communication skills, 47, 82

core competencies, 9, 188-194, 258, 314

in primary care definition, 29, 33, 36, 44-45, 148

salaried, 115, 116

see also Education and training;

Nurse practitioners;

Partnership with patients;

Physician assistants;

Physicians;

Specialists and specialty care;

Workforce

Coding, see Diagnostic classification and coding

Collaborative care, 71-72

in mental health, 9, 136-137, 304-305, 307

see also Primary care teams

Communication and interpersonal relations, 47, 82

training in, 10, 191, 194-195, 258, 307

Communities

coordination of services within, 36, 43, 71-72, 127

in primary care definition, 3, 31, 32, 33, 35-36

research on, 243

Community-Based Public Health Initiative, 196

Community health information networks (CHINs), 365

Community-oriented primary care (COPC), 28, 30, 71, 133, 351-352, 357, 369

Comorbidity, 80, 237, 289

with mental disorders, 292-293, 295

Competencies, see Core competencies

Comprehensive care, 28, 68-69

and care outcomes, 68-69

integrated services, 32, 38-41

Computer-based patient records, 44, 57, 69-70, 88, 125, 126, 142

Computer networks, 38

Consolidated Omnibus Budget Reconciliation Act, 197

Consortia, see Primary care consortium

Consultation/liaison (C/L) psychiatry, 305

Continuing medical education (CME), 142, 192, 207

Continuity of care, 28, 29, 44, 69, 117-118

and clinician-patient partnership, 56-57

and mental health care, 302

research, 241

and service integration, 32, 43-44

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Coordination of services, 32, 41-43, 55-56, 69-70, 88, 126

research, 240-241

specialty referrals and other services, 41, 55, 109-110, 124-126, 130-139, 131-132, 356

Core competencies, 9, 188-194, 258, 314

for nurse practitioners, 192-193

training, 5, 10, 183-184, 186-187, 188-194, 258

Costs and cost control, 14, 21, 64, 347-348

patient resistance, 23, 39

specialty care, 13, 63-65

and technological innovation, 24

Council on Graduate Medical Education (COGME), 14, 170-171 202, 367

Cultural sensitivity, 36, 85-86

training in, 10, 191, 194-196, 258

Culture and social norms, 35, 85-86, 329

Curricula, see Core competencies;

Education and training

D

Data sources, 222-229

development of national data set, 11, 224-225, 228-229, 260

episodes of care, 79-80, 101

patient interviews and surveys, 48-49

patient records as, 48, 57-58, 227

population-based surveys, 218, 223-224, 229n

on workforce issues, 10, 170-171, 172, 257

see also Medical Outcomes Study;

Medicare Current Beneficiary Survey;

National Ambulatory Medical Care Survey;

National Health and Nutrition Examination Survey;

National Health Interview Survey;

National Medical Expenditures Survey;

Netherlands Transition Project

Data standards, 12, 233-234, 261, 355-356

Definitions, see Primary care definition

Delivery of primary care

academic health centers' role in, 9, 24, 111-112, 143-144, 173, 257

coordination with other services, 109-110, 124-126, 130-139, 356

diversity within, 109, 296

organizational arrangements, 4, 108, 118-119

professional roles in, 110, 119-126

specialists' role in, 12, 41, 44, 110, 122-124, 238-239, 261

to underserved populations, 4, 8, 111, 126-130, 255

see also Financing of primary care;

Infrastructure development;

Integrated delivery systems;

Managed care

Demand for clinicials, 156, 165-166, 167-168

monitoring of, 5, 10, 170-171, 257

see also Geographic distribution;

Underserved population;

Workforce

Dentists and dentistry, 44, 109, 125, 165

Department of Defense (DOD), 196, 221

Department of Health and Human Services (DHHS), 11, 12, 218, 219, 220, 223

Department of Veterans Affairs (VA), 109, 196, 221

Depression, 295, 297, 298, 302

Diagnosis, see Clinical decisionmaking;

Early detection

Diagnostic and Statistical Manual for Mental Disorders (DSM), 79, 294, 295-296

Diagnostic classification and coding, 12, 228, 233, 234, 235, 261

international systems, 79, 90, 218, 294, 296

Diagnostic tests, 84

Disease prevention, see Preventive care

E

Early detection, 41, 58-59;

see also Preventive care

Educational levels, 71

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Education and training, 5-6, 19, 167-170, 179-180, 307-308

in ambulatory care settings, 10, 202-203, 258

community contexts, 191-192

continuing medical education (CME), 142, 207

in core competencies, 5, 10, 186-187, 188-194, 258

funding of, 5-6, 157-158, 166, 179, 181, 196-203, 257

interdisciplinary approaches, 6, 11, 203-206, 259-260

minority participation, 157, 169-170

of nurse practitioners, 20, 159, 160-162, 200, 206, 316

of physician assistants, 157, 196-200

of physicians, 150, 156-158, 180-187

see also Graduate medical education;

Retraining of physicians;

Undergraduate medical education

Efficiency and productivity, 15, 61-62, 115

accountability for, 33, 49

of nonphysician clinicians, 317-319, 321, 332

Elderly persons, 2, 18, 20, 60, 137, 138

Emergency care, 45, 65-66, 67, 111

Epidemiological studies, 82-83

Episodes of care, 56, 225-226

comparison of U.S. and Dutch data sets, 89-101

as unit of assessment, 48, 79-80, 226-228

Ethics and ethical behavior, 82, 192 accountability for, 33, 49

Evidence-based medicine, 82-83

F

Faculty reimbursement, 197-198

Family members and relationships, 81, 191

care givers, 35, 60

in primary care definition, 3, 31, 32, 33, 35

research on, 243

Family practice, 19, 63, 64, 77, 192

residencies, 186-187, 199

Federated Council of Internal Medicine Curriculum Task Force (FCIMCTF), 189-190

Fee-for-service (FFS), 8, 114, 115, 116, 254, 314

HMO payments to clinicians, 315n

and mental health services, 300

Financing of primary care, 113-118

impact on quality of care, 327-332, 355

payment methods and mechanisms, 8, 115-118, 254

universal coverage, 113-114, 253-254

see also All-payer system;

Capitation payments;

Fee-for-service

First-contact care, 27, 28, 29, 38-39

by non-medical professionals, 124-126, 165

For-profit ownership, 22, 108

G

Gatekeepers, 20, 39, 125

in mental health services, 302

General practitioners, 19, 41n, 63, 64, 68, 190

Geographic distribution

of managed care programs, 106-107

of physicians, 64, 67, 158

of primary care workforce, 10, 171-173, 257

Global capitation, 114-116

Graduate medical education (GME), 157, 185-187

financing, 196-203

Medicare support, 196, 197-198, 202-203, 259

as a public good, 200-201

H

Health Care Financing Administration (HCFA), 128, 197, 221, 223, 224, 254

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Health care reform, 7, 21, 113

Health care services, in primary care definition, 2, 31, 32-33, 37 -38

Health Maintenance Organization Act, 20

Health maintenance organizations (HMOs), 20, 22, 63, 106, 107, 351

payments to clinicians, 115

staffing patterns, 322-327

Health promotion, 2, 3, 18, 58, 87-88, 132, 134

Health services research, 236

HEDIS (Health Plan Employer Data and Information Set), 139

Hispanic Americans, 157

Hospital-based care, 13

excess capacity, 21

preventable, 66, 67

Households, see Family members and relationships

Humanities, 81

I

ICD, see International Classification of Diseases

Inappropriate care, 47

Income levels, 71

Information management, 3, 88, 142, 192

and accessibility of services, 46

in community contexts, 36, 44, 355-356, 361

networks, 38, 365

patient records, 43-44, 57-58, 69-70

Informed consent, 85

Infrastructure development, 141-143

for research, 11, 218-219, 235

Insurance, 116

mental health care coverage, 87, 297, 299

primary care disincentives, 116, 117, 136, 137

see also Universal coverage

Integrated delivery systems, 2, 18, 32-33, 35, 38, 143

accessibility, 45-46

and clinician training, 206-207

organization of, 22, 31, 107-108

Integrated services

in community context, 352-372

comprehensiveness, 32, 38-41

continuity in, 32, 43-44

coordination in, 32, 41-43, 126

for mental health care, 303, 304-305, 357-358

in primary care definition, 2, 29, 31, 32, 33, 38-44, 314

research, 240-241

Interdisciplinary teams, see Primary care teams

Internal medicine and internists, 19, 20, 77, 122, 156

training, 186-187, 192, 194, 199-200, 209

International Classification of Primary Care (ICPC), 80, 90, 218

International Classification of Diseases (ICD), 79, 90

and mental disorders, 294, 296

International medical graduates (IMGs), 149

J

Judgment, see Clinical decisionmaking

K

Kaiser Permanente, 107, 320-321

Kellogg, W. K., Foundation, 134, 179, 196, 222, 352

Korean Americans, 86

L

Latino populations, 195

Life-cycle curriculum, 191

Long-term care, 9, 60, 109, 114, 137-139, 256

M

Managed care, 2, 18, 21-22, 64, 105-107, 312, 356

consolidation in, 22, 108

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

geographic distribution, 106-107

and information management, 355

and mental health services, 300-301, 302

and public health, 132-133, 134-135, 355

and underserved populations, 111, 118, 119, 127-128, 172-173, 327-328

workforce impacts, 106, 313-327

Market shares, 107, 108

Medicaid, 20, 22, 130, 167-168, 196

cost-of-care studies, 64

managed care arrangements, 22, 106, 127-128, 132

Medical Outcomes Study (MOS), 63, 68

Medical savings accounts (MSAs), 117

Medicare, 20, 22, 64, 116

graduate medical education support, 196, 197-198, 202-203, 259

managed care arrangements, 22, 106, 128

nursing education support, 200

Medicare Current Beneficiary Survey (MCBS), 224

Mental health

comorbidity, 292-293, 295

and insurance reimbursement, 87, 297, 299

prevalence of disorders, 289

relation to physical health, 3, 86-87, 237, 286-288, 299

research, 237, 306

Mental health ''carve-outs," 109, 135, 136, 302-303

Mental health services, 9, 109, 135-137, 255-256, 285-308

collaborative care models, 9, 136-137, 304-305, 307

financing of, 87, 135-136, 300-304

parallel systems, 135, 304

research, 306-307

Mexican Americans, 86, 157

Minority groups, 85-86

medical education and training, 157, 169-170

see also Cultural sensitivity;

Culture and social norms

Misuse of health services, 47

Mixed practices, 122

N

National Ambulatory Medical Care Survey (NAMCS), 77, 91-92, 97-101, 223

National Board of Medical Examiners (NBME), 185

National Center for Health Statistics (NCHS), 218, 223, 228-229

National Committee for Quality Assurance (NCQA), 139

National Health and Nutrition Examination Survey (NHANES), 223

National Health Interview Survey (NHIS), 91-92, 97-101, 223

National Health Service Corps, 171-172

National Hospital Ambulatory Medical Care (NHAMC) survey, 223

National Institute for Mental Health, 305-306

National Institutes of Health, 126, 221

National Medical Expenditures Survey (NMES), 223-224, 226-227, 228

National Organization of Nurse Practitioner Faculties (NONPF), 192

Native Americans, 157

Navajo, 85

Netherlands Transition Project, 80, 89, 90-91, 93-97

Nonphysician clinicians, see Nurse practitioners;

Physician assistants

Nurse practitioners (NPs)

certification, 159-160, 316

core competencies, 192-193

education and training, 20, 159, 160-162, 200, 206, 316

in managed care settings, 320-321, 322-323

as physician substitutes, 315, 317-319, 322-323, 332

quality of care, 319-320, 333-334

responsibilities, 110, 162, 316

scope of practice, 10, 173-175, 258, 314-315, 332-333

supply, 160-162, 171, 316

work settings, 162, 316

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

O

Obstetrics and gynecology, 77, 110, 122, 123, 154, 209

Omnibus Budget Reconciliation Act, 197

Optometry and vision services, 109, 125

Orthopedists, 77

Outcomes of care, 67-70

P

Partnership with patients, 2, 3, 18, 44, 49-50, 53, 56-58, 61-62, 84-86, 329

in primary care definition, 3, 31-32, 33, 36-37

research, 241-242

theoretical bases for, 81-82

Patient education materials, 142

Patient records

in accountability systems, 48, 57-58

as research data sources, 48, 57-58, 227

Patient satisfaction, 33, 44, 48-49

with nonphysician clinicians, 319

Patients, in primary care definition, 31, 33, 34

Pediatrics and pediatricians, 19, 20, 77, 156, 192

training, 186-187, 199-200

Performance monitoring, 114, 139-141, 256

measurement, 9, 24, 47-48, 140, 141

Personal health care needs, 18, 53-54

diagnostic clusters, 53-54, 77-78

in primary care definition, 3, 31, 33, 37, 40

research, 239-240

Pew Charitable Trusts, 134, 179, 221

Pew Health Professions Commission, 202, 204, 209

Pharmacy services, 109, 125-126

Physician assistants (PAs), 110, 162-163

education and training, 20, 163-164, 198, 206, 316

in managed care settings, 320-321, 322-323

as physician substitutes, 315, 317-319, 322-323, 332

quality of care, 319-320, 333-334

scope of practice, 10, 173-175, 258, 314-315, 332-333

supply, 163-165, 171, 316

work settings, 164, 316

Physicians

demand and supply issues, 110, 149-153, 313, 315, 322-323

education and training, 150, 156-158, 180-187

geographic distribution, 64, 67, 158

primary care supply and shortages, 19, 20, 154-158

principal providers, 28, 41, 42, 123-124

and public health professionals, 353-354

retraining, 6, 11, 208-211, 260

substitution with nonphysicians, 241, 315, 317-319, 322-323, 332, 334

see also Specialists and specialty care

Pike Street Clinic Project, 303

Practice-based research networks, 12, 230-233, 260

Preferred provider organizations (PPOs), 106

Preventive care, 2, 3, 18, 41, 58-59, 70, 87-88, 132, 134, 192, 345

actual practice of, 298

in community context, 35-36, 71, 348-352

Primary care consortium, 7, 12, 141, 250-252, 261

Primary care definition, 1, 2-3, 8, 31-34, 104, 119-120, 252-253, 313

development of, 29-31

early definitions, 19, 27-29

Primary care teams, 2, 8, 42, 110, 120-121, 254-255, 313n

as care coordinators, 55-56, 138

in managed care, 327-332, 334-335

training, 11, 203-206, 259-260

Principal physicians, 28, 41n, 42, 123-124

specialists as, 41, 123-124

Productivity, see Efficiency and productivity

Professional societies, 193.

See also under names of individual societies

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Providers, see Clinicians

Psychiatry, 305

Public health, 29-30

linkage to primary care, 9, 30, 60-61, 88, 109, 131-135, 243-244, 255, 342-372

research on, 243-244

Public health nurses, 19

Public Health Service Act

Title VII funds, 157, 196, 198-200

Title VIII funds, 200

Puerto Ricans, 157

Q

Quality assessment, 47-48, 242

Quality of care, 3, 66-70

improvement programs, 107-108, 256

and nonphysician clinicians, 319-320, 321-322

performance measurement, 9, 24, 47-48, 140, 141

R

Randomized clinical trials (RCTs), 236-237

Referrals, 39, 70

coordination of, 41, 55, 131-132

incentives against, 115

to mental health professionals, 86, 135, 287, 302-303

Registered nurses (RNs), 158-159, 160

Relationships, see Collaborative care;

Partnership with patients;

Primary care teams

Requirements for clinicians, see Demand for clinicians

Research, 6, 216-217

and clinical trials, 236-237

on core concepts, 239-244

data sources, 222-229

data standards, 12, 233-234, 261, 355-356

lead agency for, 11, 219-222, 260

on mental health, 237

on specialty care, 238-239

see also Practice-based research networks

Residency, 5, 11, 186-187, 197

Residency review committees, 186

Resource-Based Relative Value Scale (RBVRS), 116, 254

Retraining of physicians, 6, 11, 208-211, 260

Robert Wood Johnson Foundation, 20, 134, 179, 199, 221

Rural settings, 20, 111, 171-172

demands on practice in, 129, 298

managed care in, 106, 111, 127, 129-130, 172-173

S

Satisfaction, see Patient satisfaction

School outreach, 59-60

Scope of care, 40-41

Scope of practice, 5, 10, 23, 173-175, 258, 314-315, 332-333

Screening programs, 87, 125

Self-care, 76, 86

Self-declaration, 208, 209

Self-efficacy, 81

Self-referral, 39, 70

Social functioning, 37-38

Social sciences, 3, 81-82

Society, see Communities;

Culture and social norms

Society of Teachers of Family Medicine (STFM), 190

Socioeconomic conditions, 71

Southeast Asians, 195

Specialists and specialty care, 12, 13-14, 24, 68, 106, 123, 153

accessibility of, 13, 65-66

clinical decision-making, 83-84

cost issues, 13, 63-65

imbalance in supply, 19, 20, 23, 122, 155-156, 169

quality issues, 66-70

research on, 238-239

role in primary care, 12, 41, 44, 110, 122-124, 238-239, 261

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×

Special-needs populations, 128-129, 255

State scope of practice laws, 5, 10, 23, 174-175, 258

Stroke, 295

Substance abuse services, 109, 135

Substitution for physicians, 241, 315, 317-319, 322-323, 332, 334

Supply of professionals, see Workforce

Surveys, see under Data sources

T

Team care, see Primary care teams

Technical quality, 47

Technological innovations, 24

Telecommunication, 46, 88

Title VII funds, 157, 196, 198-200

Title VIII funds, 200

Traditional healers, 36, 126

Triage functions, 28, 118

U

Undergraduate medical education, 180-185

competencies, 183-184

curricular reforms, 182-183

examinations, 185

faculty, 185

training in primary care settings, 5, 181-184

Underserved populations, 171-172n

and managed care programs, 111, 118, 119, 127-128, 172-173, 327-328

primary care delivery, 4, 8, 111, 126-130, 255

Underuse of care, 47, 49

Undifferentiated problems, 40n

Uninsured population, 22-23, 65, 66, 104, 113

in managed care markets, 107, 128

United States Medical Licensing Examination, 185

Universal coverage, 8, 21, 368

financing, 113-114, 253-254

Unnecessary care, 47

Urban poor, 20, 111, 130, 171-173

V

Value of primary care, 2, 3, 14, 18, 52

accessibility of services, 65-66

for clinician-patient partnership, 53, 56-58

cost impacts, 63-65

as guide through health system, 53, 54-56

links with community and family, 53, 59-61

for preventive care and health promotion, 53, 58-59

quality issues, 3, 66-70

as route to appropriate care, 53-54

Vertical integration, 107

W

Workforce, 4-5, 9-10

and care accessibility, 9, 20, 168, 169

estimation methods, 165-167

geographic maldistribution, 10, 171-173, 257

imbalances in supply, 5, 169

monitoring and data collection, 10, 170-171, 172, 257

nonphysician clinicians, 160-162, 171, 316

primary care physicians, 19, 20, 154-158

specialists, 19, 20, 23, 122, 155-156, 169

see also Education and training

Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 385
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 386
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 387
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 388
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 389
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 390
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 391
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 392
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 393
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 394
Suggested Citation:"Index." Institute of Medicine. 1996. Primary Care: America's Health in a New Era. Washington, DC: The National Academies Press. doi: 10.17226/5152.
×
Page 395
Primary Care: America's Health in a New Era Get This Book
×
Buy Hardback | $64.95 Buy Ebook | $49.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base--as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers

  • The scope of primary care.
  • Its philosophical underpinnings.
  • Its value to the patient and the community.
  • Its impact on cost, access, and quality.

This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems--important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!