title: Patient expectations for health supervision advice in continuity clinic: experience from a teaching hospital in Thailand.
abstract: OBJECTIVE
  To evaluate the ability ofpediatric residents in a continuity clinic to meet patient expectations regarding health supervision advice.
  
  
  METHODS
  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< or =0.05) and discipline 50%, 15.8%, p<0.05) among the OPD-WCC than the COC group.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Mahidol University International College, Mahidol University, Bangkok, Thailand.
authors.forename: Chulathida
authors.initials: C
authors.lastname: Chomchai
authors.forename: Suprapath
authors.initials: S
authors.lastname: Sonjaipanich
authors.forename: Suthida
authors.initials: S
authors.lastname: Cheewaisrakul
mesh_terms: D016009:Chi-Square Distribution; D003266:Continuity of Patient Care; D003376:Counseling; D003430:Cross-Sectional Studies; D006784:Hospitals, Teaching; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010372:Pediatrics / Q000193:education*; D011314:Preventive Health Services / Q000458:organization & administration*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013785:Thailand