Continuing Care: The Concept and the Research Issues

摘要

Despite the widespread belief that continuity of medical care is beneficial, empirical research on the topic to date is relatively scarce. In this publication the authors summarize and examine critically the theoretical and empirical literature. First, they review a wide range of attempts to define and measure continuity of care, discussing the strengths and weaknesses of each, the types of data they require, and their applicability to a variety of research questions. Next they review the limited evidence regarding factors hypothesized to foster continuity of care. These factors include practice setting, method of payment, and patient characteristics. And, finally, they discuss the impact of continuity upon various outcomes, including utilization patterns, efficiency, provider and patient satisfaction, and health status. The potential benefits of continuity of medical care range from improvements in the quality of service to reductions in expenditures for care. In view of the probable value of continuity and given the progress made in conceptualization, the authors argue that studies with more rigorous research designs are not only possible but would be valuable. They conclude with a useful discussion of potential sources of data for that research, both in general and with special attention to the EPSDT program for low-income children.