Identifying Primary Care Disciplines By Analyzing The Diagnostic Content Of Ambulatory Care
Identifying Primary Care Disciplines By Analyzing The Diagnostic Content Of Ambulatory Care
复制标题
通过分析门诊护理的诊断内容来确定初级护理学科
DOI：
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发表时间：
1995
影响因子：
2.9
通讯作者：
MS B. Jerald McClendon
中科院分区：
文献类型：
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作者：
M. M. Roger A. Rosenblatt;PhD L. Gary Hart;S. Gamliel;MD Mba Brian Goldstein;MS B. Jerald McClendon
背景
关于哪些医学专业是初级保健学科，存在着相当大的争议。本文通过研究主要内科学科在多大程度上为大部分人口提供全面的门诊护理来解决这一问题，这是提供初级保健的核心特征。
方法
这项研究基于1980-81年和1989-90年两个版本的全国非卧床医疗护理调查中记录的对办公室医生的非卧床访问。每个诊断被聚集到120个互不相容的诊断集群之一。初级保健接触的定义是对排名前20位的集群之一的非转诊门诊。
结果
在美国，家庭医学、普通内科和普通儿科为常见疾病提供了大多数非转诊的门诊护理。所有这三个学科都为很大一部分人口提供全面的门诊护理。妇产科医生是育龄妇女护理的重要来源，但他们往往将护理局限于产科和妇科问题；对成年妇女的大部分护理是由家庭医生和普通内科医生提供的。
结论
虽然大多数专科为不同人群提供门诊服务，但只有家庭实践、普通内科和普通儿科等传统初级保健学科为广大人口群体提供全面的门诊护理。
BACKGROUND
There is considerable controversy about which medical specialties are primary care disciplines. This paper addresses this issue by examining the extent to which the major physician disciplines provide comprehensive ambulatory care to large segments of the population, a characteristic central to the provision of primary care.
METHODS
The study is based on ambulatory visits to office-based physicians recorded in the 1980-81 and 1989-90 versions of the National Ambulatory Medical Care Survey. Each diagnosis is aggregated into one of 120 mutually exclusive diagnostic clusters. A primary care encounter is defined as a nonreferred ambulatory visit for one of the top 20 clusters.
RESULTS
Family medicine, general internal medicine, and general pediatrics provide the majority of nonreferred ambulatory care for common conditions in the United States. All three of these disciplines provide a comprehensive range of ambulatory care to large segments of the population. Obstetrician-gynecologists are an important source of care for women of childbearing age, but they tend to limit their care to obstetric and gynecologic problems; most care for adult women is provided by family physicians and general internists.
CONCLUSIONS
Although most specialties provide outpatient services to different segments of the population, only the traditional primary care disciplines of family practice, general internal medicine, and general pediatrics provide comprehensive ambulatory care to broad population groups.