Neighborhood health centers: a study of organizational concepts
Parker, Ray Kohler
Master of Architecture
The health care system, relative to serving the needs of the urban poor, is at the point of crisis. The present emphasis in health planning has been directed toward more finances, manpower and resources - on extending and improving a basically sound system so that medical care can be offered faster and more efficiently to all sectors of the population. If you consider the effectiveness of the present system in terms of meeting the health requirements of one-fourth of the urban population, the urban poor, then the emphasis is questionable. In order to provide medical care to the medically disadvantaged, a radical reorganization of services is required. Decentralization of ambulatory care is an essential step toward meeting the basic health needs of the indigent and medically indigent. This theses projects a method of decentralization by introducing a new element into the system, the neighborhood health center. The neighborhood health center would provide accessibility to comprehensive family-oriented care within a designated area. It would be a place for primary contact, an entry point into the health care system, with a means of referral of patients with acute or severe conditions to other community facilities for more extensive and specialized diagnosis or hospitalization. In order to provide a full range of medical services, the neighborhood health center would be linked into a total system of health care. This would require new concepts of organizing and providing medical services, including a new method to health planning, a change in the organization of services, a health information data system, a change in the education and orientation of health professionals, a method of organizing care areas, changes in the distribution of health services, and a means of implementing the entire system of health services. The integration of this type of organization and this new facility into a neighborhood could provide the impetus for the attack of other problems plaguing our urban system, those of an environmental, psychological and socio-economic nature. The architect's responsibility, particularly in his concern for the environment, should be to help structure and establish principles of growth and change within the urban system. He must be cognizant of the many forces that act within society and be sensitive and responsive to them. As a potential leader in society, he must attain the capacity to work with and understand the other disciplines. This inter- disciplinary contact has broadened the architect's approach to solving problems and caused him to become involved in areas not traditionally thought to be within the scope of his practice. It is within this reference that the emphasis was determined for this thesis, a study of the neighborhood health center and the new concepts required in the organization of health services.