Evaluation of medical care Methodological problems in a 6-year follow up of a family and community health center

Abstract

The inherent difficulties in assessing an on-going service which did not have any pre-planning to include evaluation as part of the service has been discussed. The main method of evaluation was by comparison of the local neighborhood health-sickness rates with the national figures for the same period (1953–1958): (1) as a ‘one-time comparison’ having shown that the local neighborhood had similar characteristics to the nation, taking into consideration the factors of age, sex, country of birth, family size, size of dwelling-units and members receiving social welfare aid; (2) as a first step in the comparison which will use the national figures as a moving-indicator over the years. The results show that, in comparison with national figures the local neighborhood has a higher birth rate. Mortality data showed similar perinatal rates, a significantly lower infant mortality rate (17.6 as compared to 34.3/1000 live births), lower standardized mortality rate, similar proportional mortality, and no maternal deaths in 578 births. Morbidity for selected specific conditions showed significantly lower incidence of diphtheria, tuberculosis, and anemia during pregnancy, identical typhoid figures, and a significantly higher number of patients reported with bacillary dysentery. There were less contacts per patient per year than for members of various sick benefit insurance schemes and there was a 78.6 per cent response to mass radiography.