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December 19, 1977

Problem-Oriented Approach to Practice-Reply

Author Affiliations

Given Health Care Center Burlington, Vt

JAMA. 1977;238(25):2697. doi:10.1001/jama.1977.03280260027009

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In Reply.—  Careful review of the "Results" section of our article should clear some of Dr Katcher's questions about the results:

  1. As stated in the article, the reported hospital use was for the entire population and represented all of their hospital experience. The 1976 rate for hospital use was, as demonstrated in the article, approximately 33% less than that experienced by the general (age-corrected) population in the country.

  2. Use of professional and ancillary services outside of the practice was examined for a random sample of our population by Blue Cross-Blue Shield (see "Methods" section). These data demonstrated no appreciable change in expenditures for services outside of the practice during the time of the study.

Unfortunately, both Drs Katcher and Buttery missed the major point of the article. This study examined change over time within a practice following the introduction of the problem-oriented system. We believe that this system