Abstract

A national commission recently recommended that public general hospitals assume the initiative in arranging neighborhood-based primary care. A survey of medically underserved census tracts conducted in Houston 11 years ago revealed that 80% of residents interviewed stated that if neighborhood clinics were developed they would use them. After ten years experience with eight neighborhood clinics, 300,000 ambulatory visits continue to be made annually to tertiary care hospitals, and more than 19.7 ± 2.1% of 90,000 yearly visits to the emergency room are for primary care problems, though a neighborhood clinic is less than half this distance from the patients home. Therefore, before communities embark on implementing the commissions recommendations, they should consider carefully the health care attitude, knowledge, and utilization behavior of their prospective patients.