Measuring the continuity and coordination of medical care in a system involving multiple providers.

Abstract:

:Patients often receive medical care from many different providers. Consequently, the various episodes of care may not be integrated into a meaningful whole, and the quality of care may suffer. Before this possibility can be evaluated, it is necessary to develop a measure of the integrating process. The authors studied the continuity and coordination of care for 197 patients attending the General Medicine Practice within a large teaching hospital. Each patient had one internist as primary physician; however, a broad array of special services were available at the hospital and were often required. Of 1,768 total visits to the hospital, 62.2% were scheduled to the practice, whereas 92.9% were with the primary physician. For visits outside the practice, coordination (defined as the percent of visits for which the primary and other physicians were aware of each other's contact with shared patients) was 35.2%. Only 74.4% of all visits were either continuous or coordinated. Continuity with a single provider may be determined by patients' needs for services by others. A combined measure of continuity with coordination, such as the one used in this study, is more appropriate for a setting with multiple providers.

journal_name

Med Care

journal_title

Medical care

authors

Fletcher RH,O'Malley MS,Fletcher SW,Earp JA,Alexander JP

doi

10.1097/00005650-198405000-00004

subject

Has Abstract

pub_date

1984-05-01 00:00:00

pages

403-11

issue

5

eissn

0025-7079

issn

1537-1948

journal_volume

22

pub_type

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