ABSTRACT
Many of the obstacles inherent in the conduct of primary care research have been overcome by an experimental program in northern New England, the Primary Care Cooperative Information Project. This project uses a medical information network in 44 rural medical practices to carry out both clinical and management research. This paper describes the developmental problems encountered and the results of some initial clinical, quality assurance, and practice management studies conducted by the network and presents observations on its future research directions.
Subject(s)
Information Systems/organization & administration , Practice Management, Medical , Primary Health Care/organization & administration , Quality Assurance, Health Care , Adolescent , Adult , Aged , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Clinical Competence , Cost-Benefit Analysis , Family Practice , Fees, Medical , Female , Humans , Hypertension/epidemiology , Hypertension/therapy , Infant , Infant, Newborn , Information Systems/economics , Internal Medicine , Male , Middle Aged , Otitis Media/drug therapy , Primary Health Care/economics , Prospective Studies , Research , Rural PopulationABSTRACT
This is the first of two papers describing the Primary Care Cooperative Information Project (COOP Project), a program that integrates the interests of community physicians, medical school faculty, and health policymakers. This integration has been accomplished through the uniting of 44 rural medical practices in Maine, New Hampshire, and Vermont with faculty at Dartmouth Medical School in clinical research, quality assurance, practice management, and continuing medical education activities. This paper describes the structure, goals, and history of the COOP Project, together with the design, cost, and output of its computerized medical information system.
Subject(s)
Information Systems/organization & administration , Medical Records , Practice Management, Medical , Primary Health Care/organization & administration , Family Practice , New EnglandABSTRACT
The incidence of rotavirus gastroenteritis in infants and children that required admission to the hospital was estimated for a defined population of approximately 105,000 individuals, including 29,000 children aged 15 years or younger whose primary health care was provided by Group Health Association, Inc, a health maintenance organization in the Washington, DC, area. From January 1977 through March 1979, almost all infants and children in this age group who required hospitalization for gastroenteritis were studied for evidence of infection with human rotavirus (HRV) and other agents. On the average, one in 272 (3.7/1,000) infants less than 12 months old and one in 451 (2.2/1,000) children aged 13 through 24 months were hospitalized for HRV disease each winter. The incidence of rotavirus gastroenteritis requiring hospitalization declined precipitously in children after the second birthday and such illness was not detected in children aged 5 years or older. The role of other agents in acute gastroenteritis requring hospitalization was minimal, compared with that of rotavirus.
