Kim Curi, Fetters Michael D, Gorenflo Daniel W
Department of Family Medicine, University of Michigan Health System, Ann Arbor, 48109-0708, USA.
Fam Med. 2006 Sep;38(8):550-5.
The value of the morbidity and mortality conference (M&MC) has received little examination in the primary care literature. We sought to understand the educational content of M&MCs by examining data from a family medicine training program.
Archived morbidity and mortality conference data (July 2001-July 2003) were retrieved from two University of Michigan family medicine adult inpatient services (one community based and one university based). We used chi-square and t test to compare demographic variables and adverse events between hospital sites. We qualitatively analyzed written comments about adverse events.
Both family medicine services shared similar diagnoses, patient volume, length of stay, and gender distribution of patients, but the community hospital had an older average patient age (67.9 years versus 52.9 years) and a higher outpatient complication rate. Analysis of the qualitative data revealed patterns of adverse events, such as an association between avoidable admissions and inadequate pain control, that could be improved through educational intervention.
Although family medicine residents' experiences in university and community hospitals were comparable, there were differences in patient populations and case complexity. Modifying the M&MC format could enhance its effectiveness as an educational tool about adverse events.
发病率与死亡率研讨会（M&MC）的价值在初级保健文献中很少受到审视。我们试图通过研究一个家庭医学培训项目的数据来了解发病率与死亡率研讨会的教育内容。
从密歇根大学的两个家庭医学成人住院服务部门（一个基于社区，一个基于大学）获取了存档的发病率与死亡率研讨会数据（2001年7月至2003年7月）。我们使用卡方检验和t检验来比较两个医院地点之间的人口统计学变量和不良事件。我们对关于不良事件的书面评论进行了定性分析。
两个家庭医学服务部门的诊断、患者数量、住院时间和患者性别分布相似，但社区医院患者的平均年龄更大（67.9岁对52.9岁），门诊并发症发生率更高。对定性数据的分析揭示了不良事件的模式，例如可避免的入院与疼痛控制不足之间的关联，这些可以通过教育干预得到改善。
虽然家庭医学住院医师在大学医院和社区医院的经历具有可比性，但患者群体和病例复杂性存在差异。修改发病率与死亡率研讨会的形式可以提高其作为不良事件教育工具的有效性。
