District nursing: the cost benefits of a population-based practice

This paper presents some serendipitous findings from an ethnohistorical study of public health nursing in rural New England. In the course of that study, a model of population-based nursing revealed itself that some would condemn as antiquated; it may, however, hold great possibilities for addressing the nation's current and future health problems, particularly health maintenance of the elderly and care of the chronically ill. In keeping with the criteria used to evaluate primary health care, the model is examined for the extent to which it is accessible, available, accountable, acceptable, comprehensive, coordinated, and cost-effective. The policy implications of this model for the organization and financing of community health care are explored.