Donaldson M S
Med Care Res Rev. 2001 Sep;58(3):255-90. doi: 10.1177/107755870105800301.
Although continuity of care is considered an essential feature of good health care, researchers have used and measured continuity in many different ways, and no clear conceptual framework links continuity to outcomes. This article of offers a reconceptualization and definition of continuity based on agency theory. It posits that the value of continuity is to reduce agency loss by decreasing information asymmetry and increasing goal alignment. Three decades of empirical literature on continuity were examined to assess whether this model would provide greater clarity about continuity. Some authors measured improved information transfer, but more appeared to assume that continuity would lead to better information. Most authors appeared to have assumed that goal alignment was present and did not measure it. The model of continuity based on agency theory appears to provide a useful conceptual tool for health services research and policy.
尽管连续性护理被视为优质医疗保健的一项基本特征,但研究人员采用了多种不同方式来使用和衡量连续性,且尚无清晰的概念框架将连续性与结果联系起来。本文基于代理理论对连续性进行了重新概念化和定义。文章认为,连续性的价值在于通过减少信息不对称和增强目标一致性来降低代理损失。对三十年关于连续性的实证文献进行了审视,以评估该模型是否能使连续性更加清晰明了。一些作者测量了信息传递的改善情况,但更多作者似乎假定连续性会带来更好的信息。大多数作者似乎假定存在目标一致性,但并未对其进行测量。基于代理理论的连续性模型似乎为卫生服务研究和政策提供了一个有用的概念工具。