Serwint Janet R, Thoma Kathleen A, Dabrow Sharon M, Hunt Lynn E, Barratt Michelle S, Shope Timothy R, Darden Paul M
Ambulatory Pediatric Association, McLean, Virginia, USA.
Pediatrics. 2006 Sep;118(3):e849-58. doi: 10.1542/peds.2006-0422. Epub 2006 Aug 21.
The goal was to compare visit data from Continuity Research Network practices with data for a nationally representative sample of pediatric visits in practice settings from the National Ambulatory Medical Care Survey.
A cross-sectional study comparing data for Continuity Research Network practice visits during a 1-week period in 2002 with data from the 2000 National Ambulatory Medical Care Survey was performed. Continuity Research Network and National Ambulatory Medical Care Survey data were derived from 30 patient visits per practice site for patients < 22 years of age, with the primary care providers being residents and practicing pediatricians, respectively.
Eighteen Continuity Research Network practices reported on 540 visits, compared with 32 National Ambulatory Medical Care Survey physicians reporting on 792 visits. Continuity Research Network patients were more likely to be black non-Hispanic or Hispanic/Latino and to have public insurance. The top 5 reasons for visits were the same for Continuity Research Network and National Ambulatory Medical Care Survey visits, although the orders varied slightly. These 5 reasons accounted for 58% of Continuity Research Network visits and 49% of National Ambulatory Medical Care Survey visits. Continuity Research Network visits were more likely to result in patient instructions to return at a specific time (78% vs 52%).
Residents in Continuity Research Network practices provide care to more underserved patients but evaluate problems that are similar to those observed in office practices; the Continuity Research Network practices thus provide important training experiences for residents who will serve both minority and nonminority children.
本研究旨在比较连续性研究网络（Continuity Research Network）机构的就诊数据与来自国家门诊医疗调查（National Ambulatory Medical Care Survey）的全国代表性儿科门诊样本数据。
开展了一项横断面研究，比较了2002年为期1周的连续性研究网络机构就诊数据与2000年国家门诊医疗调查的数据。连续性研究网络和国家门诊医疗调查的数据分别来自每个机构中30例年龄小于22岁患者的就诊情况，其中连续性研究网络的初级医疗服务提供者为住院医师，国家门诊医疗调查的为执业儿科医生。
18个连续性研究网络机构报告了540例就诊情况，相比之下，32位国家门诊医疗调查的医生报告了792例就诊情况。连续性研究网络的患者更有可能是非西班牙裔黑人或西班牙裔/拉丁裔，并且拥有公共保险。连续性研究网络和国家门诊医疗调查就诊的前5大原因相同，尽管顺序略有不同。这5大原因占连续性研究网络就诊情况的58%，占国家门诊医疗调查就诊情况的49%。连续性研究网络的就诊更有可能导致患者收到在特定时间复诊的医嘱（78%对52%）。
连续性研究网络机构中的住院医师为更多未得到充分服务的患者提供治疗，但评估的问题与门诊机构中观察到的问题相似；因此，连续性研究网络机构为将服务于少数族裔和非少数族裔儿童的住院医师提供了重要的培训经验。
