Community partnerships work.

Abstract

This adult care program epitomizes the values most recently espoused in debates on health care reform. Public/private partnerships are strengthened by emphasizing unique contributions of all resources of health care: private physicians, private pharmacists, local government, local health departments, community hospitals, business leaders, volunteer free clinics and a private medical school. The success of this program is also contingent on a high degree of patient responsibility. Patients must demonstrate a willingness to share in their care through improved capabilities of self-management. They must share in the cost of their medications, and if there is a propensity to abuse the services (unnecessary ER usage, doctor hopping), they run the risk of termination of services. Expectations are high and patients are being taught how to meet them. The next step is an intensive evaluation of outcome measures. It is felt that this evaluation must extend over a minimum of 5 years in order to be valid and demonstrate trends. We are currently pursuing funding for such an evaluation.