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Abstract
Community health centers were created 28 years ago under the Economic Opportunity Act of 1964, as a response to inequities in access to health care. Their organizational model was based on the principles of comprehensiveness, accessibility, continuity of care, and community participation.
In depth studies of Community Health Centers were conducted for a decade following their inception. Afterwards, research interest decreased substantially. The literature review underlined the importance of health centers in the delivery of health care to the poor and suggested the need for ongoing research, both qualitative and quantitative analysis.
This study determined the extent to which the original goals of the Office of Economic Opportunity (OEO) health center policy were met by a group of health centers in Allegheny County, Pittsburgh, Pennsylvania. The study examined the program similarities between federally funded centers and hospital-based health centers. It also gave an historical perspective of Community-Based Primary Care Centers in the United States.
The performance analysis was the major aspect of the analytical effort. Based on the requirements specified on OEO guidelines, a set of performance measures was chosen as the foundation for the development of the analytical framework in assessing the study's health centers. These measures consisted of comprehensiveness, accessibility, continuity of care, innovation, and financial viability.
Twenty-two centers were assessed, eleven of them received either partial or full federal support. The other eleven were hospital-based centers. The directors of these centers were interviewed by the author and another doctoral student of public health. Telephone interviews with the center directors and site visits were later conducted to collect all pertinent data for our analysis.
The major findings indicated that the overall performance of both groups does not differ essentially. The two groups failed to provide comprehensive care on site. However, virtually all of them provided the basic primary health care. In both types of health centers, services provided were geographically and financially accessible, and favored continuous care. The non-hospital-based centers provided services in a more innovative way, than those at hospital-based centers. The findings of the study also showed that the centers provided care for the most disadvantaged.
