Patient Care as a Criterion Problem

An examination of the concept of patient (P) care in 53 clinics re the suitability of the current view that P care is a unitary concept. Data were collected re 3 potential indices of care: (1) judgements of the quality of P care, (2) the extent to which nurses were observed to teach P's, & (3) the extent to which P's follow-through on clinic prescriptions as rated by their MD. These indices were related to 3 empirically derived dimensions along which out-patient clinics could vary, (A) size, (B) difficulty for the P of the illness treated, and (C) Med manageability of the illness treated. P compliance was found to be lower in clinics treating difficult illness, though the amount of P teaching was higher & care judged better. The size of the clinics was unrelated to P compliance & judgement,of the quality of care was negatively r'ed to repetition in P teaching. Med manageability of the illnesses treated was unrelated to the amount & emphasis in P teaching, & to P compliance, but evidenced a curvilinear relationship to judgements of the quality of care. In view of the very diff relationships found between parameters of clinics & the aspects of P care it was suggested that the general concept be abandoned, to be replaced by specified performance variables. AA.