Geographic Retrofitting: A Method of Community Definition in Community-oriented Primary Care Practices

摘要

Community definition is an important aspect of community health work in general and community-oriented primary care (COPC) in particular. Yet, community definitions are often nonspecific, relying ongeopolitical boundaries or local presumptions about patient populations. Such definitions are an impedimentto the precise application of sociodemographic or health status data to community health problemsor to targeted community organizing. This paper describes a technique called "geographic retrofitting"that has proved useful in establishing a rigorous definition of a practice's community based on currentpatterns of health care by the community. It also demonstrates how this approach, used in conjunctionwith geographic information systems software, facilitates more-powerful capabilities in community characterizationand intervention.