Starfield B H, Simborg D W, Horn S D, Yourtee S A
Med Care. 1976 Jul;14(7):625-36. doi: 10.1097/00005650-197607000-00008.
Coordination is a hallmark of primary care. Efforts to improve primary care services should involve assessment of the extent to which coordination is achieved. Our study in three adult and three pediatric clinics demonstrates that existing information concerning patients' problems, therapies, tests, and referrals is often not recognized by primary care practitioners. Recognition of these types of information is better when the practitioner who provides follow-up care is the same from one visit to the next. Information about visits which were anticipated by the practitioner, and particularly the content of these visits, is often neglected. The largest deficit, however, is in recognition of both the occurrence and content of visits unanticipated by the primary care practitioner. Greater efforts to achieve better coordination of care, by improving either continuity of practitioner, communication among practitioners, or the information system, are required before this essential element of primary care becomes a reality.
协调是初级保健的一个标志。改善初级保健服务的努力应包括评估协调的实现程度。我们在三家成人诊所和三家儿科诊所开展的研究表明，初级保健从业者往往无法识别有关患者问题、治疗、检查和转诊的现有信息。当提供后续护理的从业者在每次就诊时保持一致时，对这类信息的识别会更好。从业者预期的就诊信息，尤其是这些就诊的内容，往往被忽视。然而，最大的不足在于对初级保健从业者未预期到的就诊的发生情况和内容的识别。在初级保健的这一关键要素成为现实之前，需要通过改善从业者的连续性、从业者之间的沟通或信息系统，做出更大努力以实现更好的护理协调。
