Rudnick K V, Spitzer W O, Pierce J
J Med Educ. 1976 May;51(5):395-402. doi: 10.1097/00001888-197605000-00007.
In March 1972 a private family practice in Hamilton, Canada, became a teaching practice of McMaster University. Subsequently a before-and-after study was conducted to compare characteristics of the patients and the impact of the change on the practice. There was a 34 percent reduction in practice size. There was a shift to younger patients and a substantial drop in mean patient income. Utilization rates of health services rose, particularly hospitalization, even though the average length of stay decreased. Profiles of complaints and diagnoses remained very similar. Quality of care scores were comparable with those of community controls before and after the change. Gross income from clinical earnings dropped, but the amounts per person per year were very similar in the two periods. It is concluded that the "transplanted private practice" which becomes part of a school of medicine is a realistic teaching resource in primary care.
1972年3月，加拿大汉密尔顿的一家私人家庭诊所成为麦克马斯特大学的教学诊所。随后进行了一项前后对比研究，以比较患者的特征以及这一转变对诊所的影响。诊所规模减少了34%。患者群体转向更年轻的人群，平均患者收入大幅下降。卫生服务利用率上升，尤其是住院率，尽管平均住院天数减少了。投诉和诊断情况基本保持相似。护理质量评分在转变前后与社区对照相当。临床收入的总收入下降了，但两个时期的人均年收入非常相似。研究得出结论，成为医学院一部分的“移植私人诊所”是初级保健中一种切实可行的教学资源。
