Donabedian A
Inquiry. 1985 Fall;22(3):282-92.
The quality of care can be perceived to have an "epidemiology" in that it is distributed in each of two populations, one of providers and another of clients. In this review of the pertinent literature, I found, overall, that the quality of technical care is better when practitioners have better or more training, are more specialized, and are more experienced though not too old; when they provide ambulatory care by appointment to a not overly large caseload in well-equipped premises and possibly in association with colleagues; and when they provide hospital care in larger institutions with significant teaching functions. I found no consistent correlation between quality and age, sex, rurality, occupation, income, and ethnicity of patients, but there were enough intimations of a relation between socioeconomic disadvantage and poorer technical care to prompt careful study.
医疗质量可以被认为有一种“流行病学特征”，因为它分布在两个群体中，一个是提供者群体，另一个是客户群体。在对相关文献的综述中，我总体发现，当从业者接受过更好或更多的培训、更加专业化、经验更丰富（但年龄不过大）时；当他们在设备齐全的场所通过预约为数量不过多的病例提供门诊护理，并且可能与同事合作时；以及当他们在具有重要教学功能的大型机构中提供医院护理时，技术护理质量会更好。我发现患者的年龄、性别、农村地区、职业、收入和种族与医疗质量之间没有一致的相关性，但有足够的迹象表明社会经济劣势与较差的技术护理之间存在关联，这促使我们进行仔细研究。
