Question: PLEASE USE THE READING BELOW TO ANSWER THE QUESTION. PLEASE USE INFORMATION FROM READING TO ANSWER THE QUESTIONS AND DO NOT COPY OFF THE INTERNET OR I WILL THUMBS DOWN! ALSO PLEASE RESPONSE IN FULL SENTENCES AND NOT BULLET POINTS. THANK YOU QUESTION: What Is The Coordination Function As Performed By A Primary Care Physician Or Primary Care Team, And …

PLEASE USE THE READING BELOW TO ANSWER THE QUESTION. PLEASE USEINFORMATION FROM READING TO ANSWER THE QUESTIONS AND DO NOT COPYOFF THE INTERNET OR I WILL THUMBS DOWN! ALSO PLEASE RESPONSE INFULL SENTENCES AND NOT BULLET POINTS. THANK YOU

QUESTION: What is the Coordination function as performedby a Primary Care Physician or Primary Care Team, and why is it KEYto successful management of Patient Care?

READING 1:

THE CENTRALITY OF PRIMARY CARE – EXCERPTS FROM THE WORKOF BARBARA STARFIELD, M.D.

1. WHAT IS PRIMARY CARE?

EXCERPT – “Is Primary Care Essential?”Barbara Starfield, MD; The Lancet, 22 October 1994, Vol344(8930), pages 1129-1133.

The conference convened by the World Health Organization at AlmaAta in 19781 used 100 words to describe primary care; they includedessential, practical, scientifically sound, socially acceptable,universally acceptable, affordable cost, central function and mainfocus of overall social and economic development, first-levelcontact, and first elements of a continuing health care process.Serious planning for primary care requires a conceptualization thatis easily and uniformly understood, implemented, and amenable tomeasurement.

Primary care is first-contact, continuous,comprehensive, and coordinated care provided to populationsundifferentiated by gender, disease, or organ system. Theelements of first contact, continuity, comprehensiveness, andcoordination are included in most definitions proposed byprofessional organizations, agencies, and commissions [2-5]. Whenviewed from the perspective of populations as well as individualpatients, a health system that seeks to achieve these four elementswill be achieving what was envisaged in the Alma AtaDeclaration.

Primary care is only one level of a health system,albeit a central one.

Other essential levels of care include secondary care,tertiary care, and emergency care (especially for serioustrauma).

• Secondary and tertiary care are distinguished by their durationas well as by the relative uncommonness of problems that justifythem.

• Secondary care is consultative, usually short-term in nature,for the purpose of helping primary-care physicians with theirdiagnostic or therapeutic dilemmas. Secondary care may be providedby informal consultations of secondary-care physicians withprimary-care physicians, by regular visits of secondary-carephysicians to primary-care facilities for the purpose of advisingon management of patients with particular disorders (e.g.,diabetes), or by short-term referral of patients.

• Tertiary care, in contrast, is care for patients with disordersthat are so unusual in the population that primary-care physicianscould not be expected to see them frequently enough to maintaincompetence in dealing with them. When the disorder has asubstantial impact on other aspects of a patient’s health, thetertiary-care physician may have to assume long-term responsibilityfor most of the patient’s care, consulting with the primary-carephysician for problems and needs that primary-care physicians arebetter equipped to handle.

All of these other levels of care require integrationwith primary care for the patient to receive clear and consistentadvice.

2. THE SPECIAL CHARACTERISTICS OF PRIMARYCARE.

EXCERPT:  “PRIMARY CARE ASPART OF US HEALTH SERVICES REFORM,” Barbara Starfield, MD, MPH andLisa Simpson, MB, BCh, MPH; JAMA, June 23/30, 1993 – Vol269, No. 24, pp. 3136-3139.

The poor development of primary care within the US health caresystem has received relatively little attention despite evidencethat it may underlie or at least exacerbate access, quality, andcost problems. Primary care facilities make it possible forindividuals to obtain services for illnesses before they becomesevere.

Primary care services, when properly linked to specialtyservices for consultation and referral, achieve better outcomes.Primary care services are also less costly than specialty services,largely because they are less technology-intensive. Higher levelsof primary care manpower are associated with lower mortality rates.Where it has been examined as a characteristic, Primary Care istwice as important as insurance in maintaining health.

READING 2:

THE PHILOSOPHY OF MANAGEDCARE – A FOCUS ON CONTINUOUS, COMPREHENSIVE, COORDINATED HEALTHCARE FOR INSURANCE PLAN ENROLLEES:

1. Kaiser Permanente’s philosophy of Managed Care, which focuseson the primacy of Primary Care and the necessity for highlycoordinated efforts by insurers and providers, was a majorinspiration for the types of Managed Health Insurance Plansimplemented throughout the 1990s.

2. Essential to the Kaiser Permanente philosophy was the belief inthe primacy of Primary Care within the system by which personalhealth care services were delivered in the United states. Thisbelief, championed from the 1960’s and thereafter by policy makerssuch as Barbara Starfield, asserted that reasonably priced qualityhealth care could only be delivered on a routine basis if patientsworked closely and routinely with assigned Primary Care Physicians(individuals and/or teams).

3. At the heart of this belief in the centrality and primacy ofPrimary Care was a belief that Primary Care Practitioners were bestequipped to ensure that patients and their families receivedContinuous, Comprehensive, and Coordinated patient care.