From 1993 to 1997, the University of Cincinnati created a new Population Methods Unit, which used population methods (population definition, tracking, monitoring, and outreach), incorporated population-based medicine into the medical school curriculum, and conducted a "medical census" of low-income area near Cincinnati.
The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Health of the Public: An Academic Challenge.
The project, begun in 1993, built on a partnership established in 1990 between the University of Cincinnati Hospital and the Lincoln Heights Health Center, a federally qualified health center that operates two clinics and was, at the time, suffering from financial difficulties and a physician shortage.
Lincoln Heights is a city just outside of Cincinnati in which the incomes of a large proportion of the residents are below the poverty line. The university agreed to provide financial assistance and physician and pharmacist staffing to Lincoln Heights Health Center. In exchange, it was able to use the clinics for ambulatory medical education.
- Outreach workers at Lincoln Heights Health Center conducted a medical census of most of the adults living in Lincoln Heights. Some 1,076 individuals (60 percent of the population in the census) surveyed agreed to participate in the LHHC community-oriented health care program, and a tracking database was used to record initial information and to provide the ability to update patients' screening status.
- In 1995, the federal Bureau of Primary Health Care recognized Lincoln Heights Health Center as one of five winners of its annual "Models That Work" competition.
- The project developed a Population Methods Unit to train and assist health center staff in implementing population methods and assist in teaching students and faculty about population-based medicine.
- The project developed a hands-on curriculum in population-oriented health care methods for third-year medical students rotating through an ambulatory internal medicine rotation. At the beginning of the rotation, students received reading materials and a lecture on population-oriented health care.
- Students rotating through one of the affiliated health centers spent time practicing population-based methods.
- Population-oriented health care concepts were integrated into the ongoing continuing education curriculum for the Division of General Internal Medicine faculty.
Four times yearly, sessions were devoted to issues related to the practice of population methods. In addition, faculty were encouraged to use defined populations (such as health maintenance organization enrollees) as the basis for their own improvement efforts.
Project staff published articles in Academic Medicine and the Journal of General Internal Medicine. Staff also made presentations at national conferences.
The Health of the Public project originally intended to consolidate a group of clinics into a University Community Health Center that would serve a geographically defined community, but health care reforms, including managed care for low-income Medicaid recipients, prompted it to maintain the separate clinics and shift the project's focus from a geographical community to populations served by particular managed care plans.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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