Stokes Tim, Tarrant Carolyn, Mainous Arch G, Schers Henk, Freeman George, Baker Richard
Department of Health Sciences, University of Leicester, Leicester, UK.
Ann Fam Med. 2005 Jul-Aug;3(4):353-9. doi: 10.1370/afm.351.
We determined the reported value general practitioners/family physicians in 3 different health care systems place on the various types of continuity of care.
We conducted a postal questionnaire survey in England and Wales, the United States, and The Netherlands. The participants were 1,523 general practitioners/family physicians (568 from England and Wales, 453 from the United States and 502 from The Netherlands). Our main outcome measures were the perceived importance of the types of continuity of care and doctor or practice characteristics that may influence attitudes toward personal continuity of care.
The response rates were England and Wales 60% (568/946), United States 47% (453/963) and Netherlands 76% (502/660). The doctors in all 3 countries felt strongly that personal continuity remained an important aspect of good-quality care to their patients. Within a given health care system, doctors' personal and practice characteristics explained only a small part of the variance in attitudes toward the provision of personal continuity of care (England and Wales and The Netherlands r2 = 0.04, United States r2 = 0.01). The doctors in all 3 countries felt that they were currently able to provide all 3 types of continuity of care, although doctors in England and Wales were least positive about the provision of informational and management continuity across the primary-secondary care divide.
General practitioners/family physicians from 3 differing health care systems all place high value on being able to provide personal continuity of care to patients. Personal continuity of care remains a core value of general practice/family medicine and should be taken account of by policy makers when redesigning health care systems.
我们确定了在3种不同医疗体系中，全科医生/家庭医生对各类连续性医疗服务的重视程度。
我们在英格兰和威尔士、美国及荷兰开展了一项邮寄问卷调查。参与者为1523名全科医生/家庭医生（568名来自英格兰和威尔士，453名来自美国，502名来自荷兰）。我们的主要观察指标为对各类连续性医疗服务的重要性认知，以及可能影响对个人连续性医疗服务态度的医生或诊所特征。
英格兰和威尔士的回复率为60%（568/946），美国为47%（453/963），荷兰为76%（502/660）。所有3个国家的医生都强烈认为，个人连续性服务仍是为患者提供优质医疗服务的重要方面。在特定的医疗体系中，医生的个人及诊所特征仅能解释对提供个人连续性医疗服务态度差异的一小部分（英格兰和威尔士以及荷兰r² = 0.04，美国r² = 0.01）。所有3个国家的医生都觉得他们目前能够提供所有3种类型的连续性医疗服务，不过英格兰和威尔士的医生对跨越初级 - 二级医疗界限提供信息和管理连续性服务的积极性最低。
来自3种不同医疗体系的全科医生/家庭医生都高度重视能够为患者提供个人连续性医疗服务。个人连续性医疗服务仍是全科医疗/家庭医学的核心价值，政策制定者在重新设计医疗体系时应予以考虑。
