Continuity of care: incorporating patient perceptions.

Continuity of medical care has been conceptualized by some researchers as an attitude on the part of the patient and provider rather than as a succession of visits to the same provider. A perception of continuity (PC) scale containing 23 statements was developed to empirically test this conceptualization. A cross-sectional, random sample survey of adult patients in an established suburban family practice utilized a chart review and mailed patient questionnaire to assess the potential value of this scale. The PC scale had a high degree of internal reliability and a greater correlation with patient satisfaction than two commonly used provider continuity measures, even after controlling for demographic variables. The cost of ambulatory primary medical care was not significantly related to any of the continuity measures. The measurement of patient attitudes to define continuity provided information distinct from provider continuity formulas.