Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

Dietrich, A J; Olson, A L

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Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

1981 Sep-Oct
By Dietrich, A J ; Olson, A L
Source: Public Health Rep. 96(5):398-403

[PDF-1.21 MB]

English

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Alternative Title:

Public Health Rep
Personal Author:

Dietrich, A J ; Olson, A L

Dietrich, A J ; Olson, A L Less -
Description:

A primary care system was established at Zuni-Ramah Indian Health Service Hospital and clinic in New Mexico. Continuity and coordination of care were added to a health care system that was already accountable, accessible, and comprehensive. The new system offered each patient a personal health care provider who worked as a member of a multidisciplinary team. In changing the health care system, special attention was given to its cultural and political setting, the village of Zuni. After thorough discussion with community and staff, community members' concerns about patients' privacy and free choice were better understood, and special efforts were made to safeguard them. Ongoing evaluation is essential to maintain continuity. Eight months after the primary care system was begun, 64 percent of patients who came for care had established a personal relationship with a health care provider. For 59 percent of the visits during the 1-month evaluation period, patients saw their regular provider and, for 82 percent, patients saw their provider or one of his or her team colleagues. These percentages include night and walk-in visits. The system required no extra funding or staff. The political process of planning and consultation helped anticipate and alleviate the community's concerns, but resistance from physician's assistants and some physicians was unexpected. A flexible approach has led to a gradual acceptance of this voluntary system. This experience with the people of Zuni village shows that a primary care system can be started in a rural Indian Health Service facility with minimal outside help. Apparent improvements in quality of care make the continuity of primary care worthy of further consideration in the IHS and similar health services systems.
Subjects:

[+]

Continuity Of Patient Care Evaluation Studies As Topic Health Services, Indigenous Hospital Bed Capacity, Under 100 Hospitals, Public Humans Indians, North American Politics Primary Health Care
Source:

Public Health Rep. 96(5):398-403
Pubmed ID:

7291471
Pubmed Central ID:

PMCnull
Document Type:

Journal Article
Place as Subject:

New Mexico
Collection(s):

Public Health Reports
Main Document Checksum:

[+]

urn:sha256:e0efb14f2f1efc9b7d06879fab702534f294b82fd73979e18ad9d18dbe65ce15
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https://stacks.cdc.gov/view/cdc/65797/cdc_65797_DS1.pdf
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Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

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