title: Changing the paradigm: planning for ambulatory care expansion in Los Angeles County using a community-based and evidence-based model.
abstract: In 1998, Los Angeles County's Department of Health Services (DHS) embarked on a planning process to expand ambulatory care services for the county's 2.7 million uninsured and otherwise medically indigent residents. This planning process was novel in two ways. First, it used a quantitative, needs-based approach for resource allocation to ensure an equitable distribution of safety-net ambulatory care services across the county. Second, it used a new community-based planning paradigm that took into consideration the specific needs of each of the county's eight geographic service planning areas. Together, the evidence-based approach to planning and the community-based decision-making will ensure that DHS can more equitably provide for the needs of Los Angeles County's medically indigent residents.
authors.affiliation: Los Angeles County Department of Health Services, California, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Fielding
authors.forename: I
authors.initials: I
authors.lastname: Lamirault
authors.forename: B
authors.initials: B
authors.lastname: Nolan
authors.forename: J
authors.initials: J
authors.lastname: Bobrowsky
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D002391:Catchment Area, Health; D018672:Community Health Planning / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D015276:Health Care Rationing; D006801:Humans; D015141:Los Angeles; D017057:Medically Uninsured; D017146:Models, Organizational; D011635:Public Health Administration; D017664:Uncompensated Care