National Health Service Corps

Site Development Manual: Chapter 2

Exhibit 2-2: STAGING CRITERIA FOR COPC

TABLE 1.1:	Staging Criteria for COPC Functions - Defining and Characterizing the Community
STAGE 0:	No effort has been made to define or characterize a community beyond the active users of the practice.
STAGE I:	There is no enumeration of the individuals who constitute the community. The community is characterized by extrapolation from large area census data.
STAGE II:	There is no enumeration of the community, but it is characterized through the use of secondary data that correspond closely to the community for which the practice has accepted responsibility.
STAGE III:	The community can be enumerated and is actively characterized through the use of a database that includes all members of the community and that contains information to describe its demography and socioeconomic status. (Often such a data system is constructed over time from the active users of services, but approximates the community closely, e.g., at or above 90 percent coverage of the community.)
STAGE IV:	Systematic efforts assure a current and complete enumeration of all individuals in the community, including pertinent demogra- phic and socioeconomic data. For each individual, information exists that facilitates targeted outreach, e.g., address, telephone number, etc.
TABLE 1.2:	Staging Criteria for COPC Functions - Identifying Community Health Problems
STAGE 0:	No systematic efforts have been made to understand the health status or health needs of the community. Alternatively, the results from studies of the patient population are assumed to reflect the health problems in the community as a whole.
STAGE I:	Community health problems are identified through general consensus of the providers and/or community groups.
STAGE II:	Community health problems are identified by extrapolation from systematic review of secondary data, such as vital statistics, census data, large area epidemiologic data, etc.
STAGE III:	Community health problems are examined through the use of data sets that are specific to the community but tend to focus. on single health problems or health care issues.
STAGE IV:	Formal mechanisms (usually but not always epidemiologic techniques) are used to identify and set priorities among a broad range of potential health problems in the community, identify their correlates and determinants, and characterize the existing patterns of health care related to the problem.
TABLE 1.3:	Staging Criteria for COPC Functions -- Modifying the Health Care Program
STAGE 0:	No modifications are made in the primary care program in specific response to health needs of the larger community.
STAGE I:	Modifications address health problems believed to exist in the community, but are made more in response to a national or organization-wide initiative than in response to a particular problem specifically identified in the community.
STAGE II:	Modifications address important community health problems, but are chosen largely because of the availability of special resources to address that particular problem and closely follow guidelines that may not be tailored to the community's needs.
STAGE III:	Modifications in the health care program are tailored to the unique needs of the community and involve (where appropriate) both the primary care and the community/public health components of the program.
STAGE IV:	Modifications in the program involve both primary care and community/public health components and are targeted to specific high risk or priority groups, with active efforts (e.g., outreach) made to reach specific high-risk or priority groups within the community.
TABLE 1.4:	Staging Criteria for OOPC Functions -- Monitoring the Effectiveness of Program Modifications
STAGE 0:	Examination of program effectiveness is limited to the impact on the active users of health services.
STAGE I:	Program effectiveness is viewed in terms of impact on the community as a whole, but is based on subjective impressions of the practitioners and/or community groups.
STAGE II:	Program effectiveness is estimated by extrapolation from large area data or vital statistics.
STAGE III:	Program effectiveness is determined by systematic examination of a data set that is specific to the community.
STAGE IV:	Program effectiveness is determined by techniques that are specific to the program objectives, account for differential impact among risk groups, and provide information o~ the positive and negative impacts of the program.

DHHS/PHS/HRSA/Bureau of Health Care Delivery and Assistance, Community Oriented Primary Care in Action, p. 8-9.


Go To:	NHSC Home \| BHPr \| HRSA \| HHS \| Download Adobe Reader \| Freedom of Information Act Accessibility \| Privacy \| Disclaimers \| Search \| Questions/Comments