Breslau N, Mortimer E A
Med Care. 1981 Jul;19(7):741-58. doi: 10.1097/00005650-198107000-00005.
The effect of continuity of physician on satisfaction with medical care was examined in a sample of 370 families of disabled children receiving care from four specialty clinics of teaching hospitals. Families of children with myelodysplasia, cystic fibrosis (CF), cerebral palsy and multiple physical handicaps were included. A comparison of scores on the eight scales of the Patient Satisfaction Questionnaire across the four clinics revealed marked and consistent differences: patients of cystic fibrosis clinic scored significantly higher than patients of other clinics on most scales. Multiple regression analysis in which source of care (CF clinic versus other clinics), continuity of care, waiting time and patient and family characteristics (income, race, education, level of disability) were used as predictors indicated that continuity of care accounted for a large part of the association between source of care and satisfaction. Further, when continuity of physician and waiting time in the clinic were held constant, patients of the CF clinic were indistinguishable from patients of other clinics in their satisfaction with doctors and with medical care. Further analysis revealed that continuity of care contributed to patient satisfaction not only in a clinic that constitutes a patient's principal source of care, but also in a clinic in which only specialized care is given, excluding care for intercurrent illnesses or immunizations.
在一个由370个残疾儿童家庭组成的样本中，研究了医生连续性对医疗护理满意度的影响。这些家庭的孩子分别患有脊髓发育不良、囊性纤维化（CF）、脑瘫和多重身体残疾，他们正在教学医院的四个专科诊所接受治疗。对四个诊所的患者满意度调查问卷八个量表的得分进行比较后发现，存在显著且一致的差异：囊性纤维化诊所的患者在大多数量表上的得分显著高于其他诊所的患者。多元回归分析将护理来源（CF诊所与其他诊所）、护理连续性、等待时间以及患者和家庭特征（收入、种族、教育程度、残疾程度）作为预测因素，结果表明护理连续性在很大程度上解释了护理来源与满意度之间的关联。此外，当医生连续性和诊所等待时间保持不变时，CF诊所的患者在对医生和医疗护理的满意度方面与其他诊所的患者没有区别。进一步分析表明，护理连续性不仅在构成患者主要护理来源的诊所中有助于提高患者满意度，而且在仅提供专科护理（不包括治疗并发疾病或免疫接种护理）的诊所中也有此作用。
