Scherzer L N, Druckman R, Alpert J J
Med Care. 1980 Mar;18(3):289-96. doi: 10.1097/00005650-198003000-00004.
Families bringing children to the pediatric walk-in clinic at Boston City Hospital were interviewed randomly over a 15-week period. Families were classified as having a stable or unstable relationship with either a hospital or a neighborhood health center (NHC) from their answers to a structured questionnaire. Little change was found in the proportion of unstable users of health facilities from a similar study conducted in 1964, suggesting that the introduction of the NHCs and Medicaid, which increased the availability and accessibility of health services for the urban poor, has no effect on patterns of multiple utilization of health providers. The major variables affecting a family's utilization pattern are hypothesized to be the level of satisfaction toward the primary care facility, as expressed by the family, and the perceived ability of different health care facilities to deal with a particular health situation.
在15周的时间里，研究人员随机采访了带孩子前往波士顿市医院儿科随诊诊所的家庭。根据一份结构化问卷的回答，这些家庭被分类为与医院或社区卫生中心（NHC）的关系稳定或不稳定。1964年进行的一项类似研究发现，卫生设施不稳定使用者的比例变化不大，这表明NHC和医疗补助计划的引入，虽然增加了城市贫困人口获得卫生服务的机会和可及性，但对卫生服务提供者的多重利用模式没有影响。影响家庭利用模式的主要变量被假设为家庭对初级保健机构的满意度，以及不同卫生保健机构应对特定健康状况的感知能力。
