Effectiveness of patient care in a primary care clinic.

Using Brook and Stevenson's "trajectory" method of assessment of quality, both the process and outcome of medical care for 72 patients in a primary care clinic was evaluated. In terms of technical quality, evidence was found of failure to order required tests or examinations and inadequate diagnostic work-ups. The most positive findings were in the high number of x-ray examinations of adequate quality and the high proportion of adequate treatment received by patients within four diagnostic categories for which criteria had been established. Overall, more than 50 per cent of the patients were deemed to have received effective medical care. Interview data revealed some indication of patient dissatisfaction with the medical care received, as well as communication problems between physicians and patients.