Pandhi Nancy, Saultz John W
Department of Family Medicine, University of Wisconsin-Madison, WI 53715, USA.
J Am Board Fam Med. 2006 Jul-Aug;19(4):390-7. doi: 10.3122/jabfm.19.4.390.
The health system shift from doctor-patient continuity of care to team-based continuity may not match patients' preferences. This article reviews the existing medical literature regarding patients' perceptions of interpersonal continuity of care to determine which patients value interpersonal continuity and in what context.
A search of the ISI Web of Knowledge database from 1970 to April 2005 and the MEDLINE database from 1966 through April 2005 was performed to find articles that elicited patients' preferences or value for continuity of care. Thirty six articles were used for this synthesis.
Interpersonal continuity of care is important to a majority of patients, particularly those from vulnerable groups. Patients value the relationship with their physician, their physician's knowledge about them, and the ability to communicate their concerns. Over time, contact with a physician seems to lead to the development of trust and confidence. However, continuity of care is not valued by all patients or across all settings.
Future research should continue to explore the importance of interpersonal continuity to patients. In particular, are there medical consequences when those whom desire continuity do not receive it? Clinicians should consider incorporating patients' preference for continuity into their office scheduling procedures.
医疗系统从医患连续性照护向团队式连续性照护的转变可能不符合患者的偏好。本文回顾了现有的医学文献,这些文献涉及患者对人际连续性照护的看法,以确定哪些患者重视人际连续性以及在何种背景下重视。
检索了1970年至2005年4月的ISI科学网数据库以及1966年至2005年4月的MEDLINE数据库,以查找引出患者对照护连续性的偏好或重视程度的文章。36篇文章用于本综述。
人际连续性照护对大多数患者很重要,尤其是弱势群体中的患者。患者重视与医生的关系、医生对他们的了解以及表达自身担忧的能力。随着时间推移,与医生的接触似乎会促进信任和信心的建立。然而,并非所有患者或在所有情况下都重视连续性照护。
未来的研究应继续探讨人际连续性对患者的重要性。特别是,那些渴望连续性照护的患者若未得到,是否会有医学后果?临床医生应考虑将患者对连续性照护的偏好纳入其门诊安排程序中。