The ecology of medical care revisited.

Since its publication in the Journal in 1961, “The Ecology of Medical Care,” by White et al.,1 has provided a framework for thinking about the organization of health care, medical education, and research (Figure 1). This conceptualization, inspired in part by careful reporting on the part of British general practitioners,2 suggested that in a population of 1000 adults, in an average month, 750 reported an illness, 250 consulted a physician, 9 were hospitalized, 5 were referred to another physician, and 1 was referred to a university medical center. These data have been used repeatedly by investigators, authors of textbooks, task . . .

[1]  E. Stoller,et al.  Patterns of illness behavior among rural elderly: preliminary results of a health diary study. , 1992, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[2]  M. Fleming,et al.  The Family Physician , 1994, Alcohol health and research world.

[3]  Iglehart Jk,et al.  The American health care system--expenditures. , 1999 .

[4]  M. Labrecque,et al.  Need for an Institute of Primary Care Research within the Canadian Institutes of Health Research. , 1999, Canadian family physician Medecin de famille canadien.

[5]  T. Lee Ecology in evolution. , 2001, The New England journal of medicine.

[6]  R. Arnett,et al.  Informing American Health Care Policy: The Dynamics of Medical Expenditure and Insurance Surveys, 1977-1996 , 1999 .

[7]  I. McWhinney An introduction to family medicine , 1981 .

[8]  A. Wall,et al.  Book ReviewTo Err is Human: building a safer health system Kohn L T Corrigan J M Donaldson M S Washington DC USA: Institute of Medicine/National Academy Press ISBN 0 309 06837 1 $34.95 , 2000 .

[9]  F J Ascione,et al.  Exploring the Iceberg: Common Symptoms and How People Care for Them , 1987, Medical care.

[10]  B. Greenberg,et al.  The ecology of medical care. , 1961, The New England journal of medicine.

[11]  W. Rakowski,et al.  Daily Illness Characteristics and Health Care Decisions of Older People , 1991, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[12]  K. White Life and death and medicine. , 1973, Scientific American.

[13]  L. Green,et al.  Potential of practice-based research networks: experiences from ASPN. Ambulatory Sentinel Practice Network. , 1994, The Journal of family practice.

[14]  R. Kuttner THE AMERICAN HEALTH CARE SYSTEM : HEALTH INSURANCE COVERAGE , 1999 .

[15]  S. Kooiker Exploring the iceberg of morbidity: a comparison of different survey methods for assessing the occurrence of everyday illness. , 1995, Social science & medicine.

[16]  J. Horder,et al.  Illness in general practice. , 1954, The Practitioner.

[17]  R. Haggerty,et al.  The Diary as a Research Instrument in the Study of Health and Illness Behavior: Experiences with a Random Sample of Young Families , 1972, Medical care.

[18]  W B Schwartz,et al.  Rationing health care: the choice before us. , 1990, Science.

[19]  T. Bodenheimer,et al.  The American health care system--physicians and the changing medical marketplace. , 1999, The New England journal of medicine.

[20]  V. Fuchs The health sector's share of the gross national product. , 1990, Science.