Comment

Integration of personal and community health care

A better alignment of a population-based public health approach with personal health services is needed urgently, along with better integration of personal health care and public health. To quote van Weel et al., primary care needs to be organized on the principle of care for individuals in the context of the population, and the future of primary care, and health care in general, will depend on how effectively a community-oriented approach and its contribution to equity and social cohesion is achieved.2 The recognition that health systems play a key role in public health has been endorsed by the World Health Organization (WHO) in the report ‘Primary Health Care – Now More Than Ever’, published on the 30th anniversary of the international conference of Alma-Ata.

The current fragmented1 US health care sector provides lower quality care than most industrialized nations and at a higher cost.2–4 Efforts to address this low value, including the Patient Protection and Affordable Care Act, cannot succeed without a reinvigoration of a primary-care–based, community-centered health system.5–9 The Affordable Care Act provides multiple provisions for supporting a patient-centered medical system, improving training and enhancing reimbursement of the primary care workforce, and enabling community involvement.