Referral-outreach program links community clinics and hospital.

In the San Diego area, a special program has established a linkage system between a major medical center and community clinics that provide primary care to persons in generally low-income, medically underserved neighborhoods. This system ensures continuity of care for the clinic patients through referrals to the medical center and follow-up back at the clinics and through provision of special services by the medical center's physicians onsite at the clinics.

Ray JL ，Hogue VJ 《-》

Hospitals and the poor: strategies for primary care.

Cooke J ，Brooks P 《-》

Urban hospital reaches out to its area's aged.

In the medically underserved Bronx, NY, a hospital's gerontology center provides screening, health education, and outpatient services to elderly residents in the community.

Riklan M ，Larson DL ，Gerardi G ，Beard JM ... -  《-》

Establishing a profitable outpatient community nursing center.

In 1983, the newly implemented prospective payment system reduced the length of hospital stays, thereby curtailing many of the services that patients traditionally received. The Division of Nursing at Memorial Medical Center of Long Beach, California identified many patient needs that were no longer being addressed during the inhospital stay and began looking for a way for nurses to meet these needs on an outpatient basis. The result was the formation of Memorial Medical Center's Community Nursing Center.

Pappas CA ，Van Scoy-Mosher C 《JOURNAL OF NURSING ADMINISTRATION》

Equity in veterans' mental health care: Veterans Affairs medical center clinics versus community-based outpatient clinics.

This study examined differences in structures and processes of mental health care at Veterans Administration (VA) primary care clinics, comparing VA medical center (VAMC) clinics to community-based outpatient clinics (CBOCs). A survey was conducted of nurse managers at 46 of 49 primary care clinics (23 VAMC clinics and 23 CBOCs) within a VA health care network in the south central United States. Integration of care and services overall was comparable between VAMC clinics and CBOCs. The service mix differed. Integrated CBOCs more often offered group therapy, medication management, and smoking cessation. Integrated VAMC clinics more frequently used written suicide protocols and depression screening. Distance to offsite specialty care and wait times for referrals were shorter for patients at VAMCs than at CBOCs. The provision of mental health care at CBOCs is comparable to that at VAMC clinics, although differences in patient access to offsite care indicate that full equity was not achieved at the time of the survey. Since 2000, the VA has initiated several programs to address this need.

Kirchner JE ，Owen RR ，Dockter N ，Kramer TL ，Henderson K ，Armitage T ，Allee E ... -  《AMERICAN JOURNAL OF MEDICAL QUALITY》