Strategies for developing a comprehensive health care system

Abstract

The South Dade Health Care System represents one community's response to its health care challenges. Using concepts of comprehensive health care that had been demonstrated elsewhere, the community developed solutions to meet its needs, with an emphasis on those that would use established resources while new approaches were being added. After four years of operation, the system now provides most primary care services for over 40,000 people through more than 120,000 annual ambulatory patient visits, as well as arranging for consultations, hospitalization, and tertiary care services. A chronological description of the strategies used in the planning and development of this program—from its conception to being a fully operational accomplishment—is presented, so that other community groups facing a similar challenge may gain from our experience.