Mattsson L G, Westman G
Department of Mathematics, Royal Institute of Technology, Stockholm, Sweden.
Fam Pract. 1987 Dec;4(4):251-9. doi: 10.1093/fampra/4.4.251.
Continuity of care is an important factor in the quality of primary care. Unfortunately there is no common view about its definition, measurement, determinants or relationship to outcome. Using a visit-based approach to the measurement of continuity, the present study examines the effects of organizational changes, including the introduction of a new appointment system, on physician continuity at a Swedish primary health care centre. This allows the concepts of random and potential continuity to be introduced, providing norms against which the achieved levels of actual continuity can be rated. The results show that the actual physician continuity, although not particularly high, was considerably higher than what could be expected according to chance alone (random continuity). Moreover, actual continuity did appear to increase after the organizational changes were implemented--absolutely as well as in relation to potential continuity. The importance of reducing the mobility of physicians is emphasized in order to further improve the situation.
连续性医疗是初级医疗质量的一个重要因素。不幸的是，对于其定义、测量方法、决定因素或与结果的关系，并没有统一的看法。本研究采用基于就诊的方法来衡量连续性，考察了包括引入新预约系统在内的组织变革对瑞典一家初级医疗中心医生连续性的影响。这使得随机连续性和潜在连续性的概念得以引入，从而提供了可用于评估实际连续性达成水平的标准。结果表明，实际的医生连续性虽然不是特别高，但大大高于仅根据概率所预期的水平（随机连续性）。此外，在实施组织变革后，实际连续性确实出现了增加——无论是绝对水平还是相对于潜在连续性而言。为了进一步改善这种情况，强调了减少医生流动的重要性。
