The Adult Primary Care Clinic: A Case Study of One Approach to Developing a Primary Care Clinic in an Army Medical Center.
Abstract
As the military health services system moves into managed care, tertiary care facilities are recognizing the need to develop their primary care capabilities. In 1994, Fitzsimons Army Medical Center opened their Adult Primary Care Clinic (APCC). The purpose of this case study was to describe the original staffing and enrollment plans, actual staffing and enrollment, and the patients served by the APCC. The study utilized interviews, documents, direct observation, and participant observation. The patients are described using a 10% sample of the enrolled population. The planned physician to beneficiary ratio of 0.36 to 1000, and the actual ratio of 0.33 to 1000, are well below the staff model HMO ratio of 0.983 to 1000. The patients served by the APCC are older than the population served by the HMOs. The overall ambulatory utilization rate for the APCC patients was 9.19 visits per year, compared to the HMO rate of 5.4 visits per year. Seventy-two percent of the sample patients were found to have one or more chronic conditions. Based on the older population, higher utilization rates, and the high percentage of patients with chronic diseases, the clinic should be staffed with more physicians and physician extenders than staff model HMOs.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 1995
- Accession Number
- ADA313820
Entities
People
- Doreen M. Lounsbery