Shortell S M
Med Care. 1976 May;14(5):377-91. doi: 10.1097/00005650-197605000-00001.
Continuity of medical care is conceived as the extent to which services are received as part of a coordinated and uninterrupted succession of events consistent with the medical care needs of patients. Two operational measures are proposed, based on the Gini and CON indices of concentration. Examples of their application are provided using the 1970 CHAS-NORC national study of health services utilization. The validity of the proposed measures is assessed in a preliminary fashion, and some commonly held assumptions about the relationship between access, quality, and continuity of care are challenged. Advantages of the proposed measures include their ability to summarize a distribution, the availability of data for construction, the relative ease of computation and interpretation, and their sensitivity to organizational changes in the delivery of health services.
医疗服务的连续性被理解为，服务作为与患者医疗需求相一致的协调且不间断的一系列事件的一部分而被接受的程度。基于基尼系数和集中指数（CON），提出了两种操作性测量方法。利用1970年CHAS - NORC全国卫生服务利用研究提供了它们的应用示例。对所提出测量方法的有效性进行了初步评估，并对一些关于医疗服务可及性、质量和连续性之间关系的普遍假设提出了质疑。所提出测量方法的优点包括能够汇总分布情况、有构建数据的可用性、计算和解释相对容易，以及对卫生服务提供中的组织变化具有敏感性。
