Comparison of a community clinic with a hospital out-patient clinic in rheumatology. 1996

P S Helliwell
Rheumatology and Rehabilitation Research Unit, University of Leeds.

Community clinics are increasingly advocated as a way of delivering specialist health care. In this study, a hospital-based clinic is compared to a rotating community clinic in terms of descriptive consultation data, patient satisfaction, case mix and cost. Among other things, community clinics were more local (1.6 vs 4.9 miles), involved less waiting for the first appointment (47 vs 27% seen within 1 month), provided longer consultation times (49 vs 31% 20 min appointments) and produced more satisfactory consultations (82 vs 52% said their questions were always answered). Consultation data, however, showed that less patients were seen in the community clinic (8.6 vs 14.1 patients/doctor/clinic), with a higher old/new ratio (6.04 vs 3.96) and the cost per patient was higher (15.93 pounds vs 10.35 pounds). No differences were found in the case-mix data.

UI MeSH Term Description Entries
D010044 Outpatient Clinics, Hospital Organized services in a hospital which provide medical care on an outpatient basis. Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D003151 Community Health Centers Facilities which administer the delivery of health care services to people living in a community or neighborhood. Neighborhood Health Centers,Satellite Centers,Center, Community Health,Center, Neighborhood Health,Center, Satellite,Centers, Community Health,Centers, Neighborhood Health,Centers, Satellite,Community Health Center,Health Center, Community,Health Center, Neighborhood,Health Centers, Community,Health Centers, Neighborhood,Neighborhood Health Center,Satellite Center
D003953 Diagnosis-Related Groups A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system. Case Mix,DRG,Diagnosis Related Group,Diagnosis-Related Group,Case Mixes,DRGs,Diagnostic-Related Group,Group, Diagnostic-Related,Groups, Diagnostic-Related,Diagnosis Related Groups,Diagnostic Related Group,Diagnostic-Related Groups,Group, Diagnosis Related,Group, Diagnosis-Related,Group, Diagnostic Related,Groups, Diagnosis Related,Groups, Diagnosis-Related,Groups, Diagnostic Related,Related Group, Diagnosis,Related Groups, Diagnosis
D012219 Rheumatology A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis.
D017048 Health Care Costs The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. Medical Care Costs,Treatment Costs,Costs, Medical Care,Health Costs,Healthcare Costs,Cost, Health,Cost, Health Care,Cost, Healthcare,Cost, Medical Care,Cost, Treatment,Costs, Health,Costs, Health Care,Costs, Healthcare,Costs, Treatment,Health Care Cost,Health Cost,Healthcare Cost,Medical Care Cost,Treatment Cost

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