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Evaluation of Hospital‐Sponsored Primary Care Group Practice: A National Demonstration *

Background ONE OF THE MOST CHALLENGING issues facing hospitals in the 1980s is how to respond to growing community expectations and needs in an environment of increased competition, regulation, and scarcity of resources. These expectations and needs are particularly apparent in the areas of ambulatory and primary care in underserved communities. As one strategy to meet these needs, the Robert Wood Johnson Foundation developed a national demonstration program in Hospital/Medical Staff Sponsored Primary Care Group Practice which has become known as the Community Hospital Program (CHP). This program was one of several initiatives of the Foundation in the mid-to-late 1970s designed to increase access to care including a number of rural health care projects, primary care manpower training programs, and municipal hospital projects. The Federal government also recognized this need with the passage of the Primary Health Care Act of 1978: which authorized funding for primary care centers in underserved areas. The present article describes the CHP, outlines the major evaluation questions to be addressed, presents a conceptual framework for considering these questions, and provides some preliminary and partial analyses. It is likely that the approach taken to the present evaluation and what will be learned from it will prove helpful to other health care organizations in their attempts to develop and implement innovative programs in a changing environment.