Starfield Barbara, Chang Hsien-Yen, Lemke Klaus W, Weiner Jonathan P
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
J Ambul Care Manage. 2009 Jul-Sep;32(3):216-25. doi: 10.1097/JAC.0b013e3181ac9ca2.
Approximately 7 of 10 (and 95% of the elderly) people in US health plans see one or more specialists in a year. Controlling for extent of morbidity, discontinuity of primary care physician visits is associated with seeing more different specialists. Having a general internist as the primary care physician is associated with more different specialists seen. Controlling for differences in the degree of morbidity, receiving care from multiple specialists is associated with higher costs, more procedures, and more medications, independent of the number of visits and age of the patient.
在美国参与医保计划的人群中，约十分之七（以及95%的老年人）每年会看一位或多位专科医生。在控制发病率的情况下，初级保健医生就诊的不连续性与看更多不同专科医生有关。以普通内科医生作为初级保健医生与看更多不同专科医生有关。在控制发病率差异的情况下，接受多位专科医生的治疗与更高的费用、更多的诊疗程序和更多的药物使用有关，这与就诊次数和患者年龄无关。
