The Kaiser Permanente Medical Care Program is the largest group practice HMO in the United States (Friedman et al., 2000). Kaiser Permanente Northern California serves the Oakland-San Francisco Bay Area, Santa Clara and Sacramento Counties, and counties north of San Francisco. Kaiser Permanente Southern California serves residents in seven southern California counties: Los Angeles, Orange, San Bernardino, San Diego, Riverside, Kern, and Imperial. Kaiser Permanente Northwest (KPNW) operates in the Portland, Oregon-Vancouver, Washington area and in two smaller communities, Salem, Oregon and Long-view-Kelso, Washington, each about 50 miles distant. Each of these regional entities operates its own health research department and manages its own databases (Friedman et al., 2000; Petitti, 2001).
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