Sundelin C, Vuille J C
Acta Paediatr Scand. 1976 Mar;65(2):193-200. doi: 10.1111/j.1651-2227.1976.tb16536.x.
The data gathered in connection with a routine health screening program for 4-year-olds were used in order to test a number of hypotheses concerning factors which might have influenced the effectiveness of the program, as well as concerning the quality of preventive care delivered to the children before the age of 4 years. It was found that preventive care of relatively high quality delivered to children 0-3 years of age had not reduced the prevalence of previously undetected health problems at 4 years of age. Furthermore, the analysis demonstrated substantial differences between physicians in the rates of correct and unnecessary referrals. Only a small part of these differences could be attributed to professional status or specific experience with the program. They consisted essentially in varying thresholds for what was perceived as a health problem needing treatment, and were considered as a matter of personal temperament. True differences of quality did occur but were less prominent. The implications of these findings with regard to the continuation of the program are discussed.
为检验一系列关于可能影响该项目效果的因素以及4岁前儿童所接受预防保健质量的假设，我们使用了与一项针对4岁儿童的常规健康筛查项目相关收集的数据。结果发现，为0至3岁儿童提供的相对高质量的预防保健并未降低4岁时先前未被发现的健康问题的患病率。此外，分析表明，医生在正确转诊率和不必要转诊率方面存在显著差异。这些差异中只有一小部分可归因于专业地位或该项目的特定经验。它们主要在于对被视为需要治疗的健康问题的认知阈值不同，被认为是个人性格问题。质量上的真正差异确实存在，但不太显著。本文讨论了这些发现对该项目延续的影响。
