Wall E M
J Fam Pract. 1981 Oct;13(5):655-64.
Continuity of care is central to the philosophy and teaching of family medicine. Studies of continuity have yielded conflicting results with regard to outcomes. Reasons for this include a failure to agree upon a theoretical definition of continuity as well as failure to account for a number of influential determinants of the continuity process. It is suggested that continuity is an attitude based upon prior knowledge of and for each participant in the medical encounter. This attitude is made operational in a process consisting of five continuity dimensions: chronological, geographical, interdisciplinary, interpersonal, and informational. A working model of analysis is proposed, and the results of various studies are critically assessed. Future research in the area of continuity of care must provide reliable measures of the different continuity dimensions followed by well-controlled trials assessing the impact of these dimensions on the satisfaction, comfort, and health status of patients.
连续性医疗是家庭医学理念和教学的核心。关于连续性的研究在结果方面产生了相互矛盾的结论。造成这种情况的原因包括未能就连续性的理论定义达成一致，以及未能考虑到连续性过程中的一些有影响力的决定因素。有人认为，连续性是一种基于对医疗接触中每个参与者的先前了解而形成的态度。这种态度在一个由五个连续性维度组成的过程中得以实施：时间顺序、地理、跨学科、人际和信息维度。本文提出了一个分析工作模型，并对各项研究的结果进行了批判性评估。未来在连续性医疗领域的研究必须提供不同连续性维度的可靠测量方法，随后进行严格控制的试验，以评估这些维度对患者满意度、舒适度和健康状况的影响。
