Patient Expectations for Health Supervision Advice in
Continuity Clinic: Experience from a Teaching Hospital
in Thailand
Chulathida Chomchai MD*,
Suprapath Sonjaipanich MD**, Suthida Cheewaisrakul MD***
Affiliation :
* Mahidol University International College, Mahidol University, Bangkok, Thailand
** Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Department of Pediatrics, Chaophrayomaraj Hospital, Ministry of Public Health, Bangkok, Thailand
Background and
Objective : To evaluate the ability of pediatric residents in a continuity clinic to meet patient expectations
regarding health supervision advice.
Material and Method: This was a cross sectional prospective study conducted at the continuity clinic (COC) and outpatient
well-child clinic (OPD-WCC) at the Department of Pediatrics Siriraj Hospital in 2008. The patients attending both clinics
over a four-week period were asked to participate in a 2-part questionnaire. The first part, participants were asked to rank
six health supervision topics in the order of their perceived importance. After the visit, the participants rated the advice
quality given in each topic. The top three most-desired advices were termed ‘Priority Topics’ and the researchers categorized
the visit quality as Interactive, Informative, or Missed Opportunity (MO) according to the participants’ perceived level of
interaction. The participants were not aware of the ‘Priority Topic’ grouping prior to their participation. Main outcome
measures were the proportions of Interactive visits and MO visits in for each of the six focus topics in the COC vs. OPD-
WCC setting.
Results : The COC setting reported more Interactive sessions when the topic is discipline (31.6%, 9.1%, p≤0.05) than the
OPD-WCC group, as well as more Informative sessions when the topics were behavior and dental care. There were also
more MO in dental (50%, 0%, p≤0.05) and discipline 50%, 15.8%, p≤0.05) among the OPD-WCC than the COC group.
Conclusion : Physicians are better able to meet their patient’s expectation regarding health supervision in a continuity
setting. They are also more likely to be interactive regarding their advice and are less likely to miss the opportunities to
address issues desired by their patient.
Keywords : Continuity of care, Continuity clinic, Child health supervision, Patient satisfaction
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