Physician experience with pediatric inpatient care in Washington State.
Physician experience with pediatric inpatient care in Washington State.
复制标题
华盛顿州儿科住院护理的医生经验。
作者：
S. Melzer;D. Grossman;F. Rivara
目的
确定华盛顿州儿科医生和家庭医生担任儿科住院患者主治医生的频率。
设计
回顾性审查全州医院出院数据。
科目
1989年至1990年期间，华盛顿州平民医院所有18岁以下非手术诊断出院患者的主治医生。
结果
使用医疗名册，确定了93%（n = 181，581）出院的主治医生的自我鉴定专业。儿科医生和家庭医生分别占所有合格患者的61%和28%。在全州范围内，97%（n = 555）的儿科医生和86%（n = 939）的家庭医生在2年的研究期间担任至少一名住院患者（包括健康新生儿）的主治医生。儿科医生和家庭医生的平均年出院人数分别为78人和14.5人。排除健康新生儿，儿科医生和家庭医生的年出院人数中位数分别为25人和3人。5%的主治医生为50%的健康新生儿以外的诊断住院儿童提供住院护理; 50%的主治医生照顾95%的患者。在农村医院，家庭医生担任44%的儿科住院患者的主治医生，儿童接受家庭医生护理的可能性是城市中心住院儿童的3.3倍。
结论
大多数儿科医生和家庭医生只是偶尔担任住院儿童的住院主治医生。这些发现质疑在许多儿科和家庭医学培训项目中强调住院护理是否仍然是一个适当的目标。
OBJECTIVE
To determine the frequency with which pediatricians and family physicians in Washington State serve as attending physicians for pediatric inpatients.
DESIGN
Retrospective review of statewide hospital discharge data.
SUBJECTS
Attending physicians for all patients younger than 18 years of age with nonsurgical diagnoses discharged from civilian hospitals in Washington State during 1989 and 1990.
RESULTS
Using medical rosters, the self-identified specialty of the attending physician was determined for 93% (n = 181,581) of discharges. Pediatricians and family physicians were listed as attending for 61% and 28%, respectively, of all eligible patients. Statewide, 97% (n = 555) of all pediatricians and 86% (n = 939) of all family physicians served as attending physicians for at least one inpatient, including healthy newborns, during the 2-year study period. The median annual number of discharges per physician was 78 for pediatricians and 14.5 for family physicians. Excluding healthy newborns, the median annual number of discharges was 25 for pediatricians and 3 for family physicians. Five percent of the physician attending group provided inpatient care for 50% of all children hospitalized with diagnoses other than healthy newborn; 50% of attending physicians cared for 95% of the patients. In rural hospitals, where family physicians served as attending physicians for 44% of pediatric inpatients, children were 3.3 times more likely to receive their care from family physicians than those hospitalized in urban centers.
CONCLUSIONS
Most pediatricians and family physicians serve as inpatient attending physicians for hospitalized children only infrequently. These findings question whether the emphasis on inpatient care in many pediatric and family medicine training programs remains an appropriate goal.