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Primary Care and Its Impact on Hospitalization

Mutya San Agustin, MD; Lewis Goldfrank, MD; Robert Matz, MD; Christine Suberman, MD; David Hamerman, MD; Robert Bloom, MBA; Donna Pitter

Arch Intern Med. 1976;136(11):1262-1266.

Abstract
Ambulatory care services have been reorganized in a New York City hospital. A newly developed Neighborhood Family Care Center (NFCC) replaced the outpatient clinics. The NFCC and both inpatient and emergency services are totally integrated so as to overcome many of the deficiencies that previously existed in ambulatory care, such as inferior quality of care, minimal academic involvement, fragmentation of services, overspecialization, and unresponsiveness to patients' needs. A review of all patients admitted to the Adult Medical Service has shown a statistically significant decrease in admission rates for diabetic coma-acidosis, severe hypertension, congestive heart failure, cerebrovascular accidents, and severe asthma during the 18 months following the reorganization of ambulatory care. Analysis of cost effectiveness of these changes on the utilization of hospital beds indicates the potential for reduced expenditures of limited health care dollars.

(Arch Intern Med 136:1262-1266, 1976)

Author Affiliations
From the Departments of Medicine, Pediatrics, and Ambulatory Care Services, Montefiore-Morrisania Hospital Affiliation, and the Albert Einstein College of Medicine, Bronx, NY.

Footnotes
Received for publication Jan 7, 1976; accepted March 31.

Reprint requests to Ambulatory Care Services, North Central Bronx Hospital, 3424 Kossuth Ave, Bronx, NY 10467 (Dr San Agustin).

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