Soyer Tutku, Tekşam Ozlem, Türkmen Feyza, Cakmak Aytül, Cakmak Murat
Department of Pediatric Surgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.
Turk J Pediatr. 2009 Nov-Dec;51(6):582-6.
Pediatric trauma is the leading cause of mortality and morbidity in children. A questionnaire was applied to evaluate physicians' attitudes and perception of pediatric trauma cost. Physicians working in the field of pediatric trauma (namely those who work in emergency services, pediatrics and pediatric surgery departments; who are consulted regarding pediatric traumas; and those for whom pediatric trauma patients constitute the majority of their patient spectrum) were enrolled in the survey. A questionnaire was administered to elicit the demographic data, features of pediatric trauma in their practice, self-perception of pediatric trauma knowledge, estimation of trauma severity, parameters used for pediatric trauma diagnosis, and perception of pediatric trauma score (PTS) and trauma cost. A total of 103 physicians responded to the questionnaire (median age: 30.8 +/- 5.6 years; range: 24-56). Of the 103 respondents, 49 were males (47.6%) and 54 were females (52.4%). Physicians responding to the questionnaire were specialists in Pediatrics (32.9%), Pediatric Surgeons (5.9%), Emergency Medicine Specialists (2.9%), and residents (47.6%) in those three disciplines in University Hospitals, Public Hospitals and Research Hospitals. Physicians reported falls (58.1%) as the most common cause of trauma, and noted head injuries with an incidence of 49.9% in their trauma practice. Physicians' self-perception of their pediatric trauma knowledge was questioned in three categories as: overall, diagnosis and treatment of trauma. They reported that their knowledge of pediatric trauma overall and regarding diagnosis and treatment was "efficient" at rates of 87.4%, 83.6% and 74.8%, respectively. However, while 76.7% of physicians perform radiological evaluations in all trauma patients, only 56.3% of them use laboratory tests routinely in diagnosis. Participants reported that cost of trauma was mostly affected by severity of trauma (49.5%) and least affected by the patient's sex (64.1%). They also believed that radiologic evaluations (66%) accounted for the largest portion of trauma cost and the cost of consultations (44.7%) for the smallest portion. In conclusion, we suggest that although most physicians were aware of cost factor in trauma, they did not consider trauma costs in diagnosis and management.
儿童创伤是儿童死亡和发病的主要原因。应用一份问卷来评估医生对儿童创伤成本的态度和认知。参与调查的医生为从事儿童创伤领域工作的人员（即在急诊服务、儿科和小儿外科部门工作的人员；就儿童创伤问题接受咨询的人员；以及儿童创伤患者占其患者群体大多数的人员）。发放一份问卷以获取人口统计学数据、他们在实践中儿童创伤的特征、对儿童创伤知识的自我认知、创伤严重程度的估计、用于儿童创伤诊断的参数以及对儿童创伤评分（PTS）和创伤成本的认知。共有103名医生回复了问卷（中位年龄：30.8±5.6岁；范围：24 - 56岁）。在103名受访者中，49名是男性（47.6%），54名是女性（52.4%）。回复问卷的医生包括大学医院、公立医院和研究医院中这三个学科的儿科专家（32.9%）、小儿外科医生（5.9%）、急诊医学专家（2.9%）以及住院医师（47.6%）。医生报告跌倒（58.1%）是最常见的创伤原因，并指出在他们的创伤实践中头部受伤的发生率为49.9%。从总体、创伤诊断和治疗三个类别对医生对其儿童创伤知识的自我认知进行了询问。他们报告称，他们对儿童创伤总体以及诊断和治疗方面的知识“有效”的比例分别为87.4%、83.6%和74.8%。然而，虽然76.7%的医生对所有创伤患者都进行放射学评估，但其中只有56.3%的医生在诊断中常规使用实验室检查。参与者报告称，创伤成本大多受创伤严重程度影响（49.5%），受患者性别影响最小（64.1%）。他们还认为放射学评估（66%）占创伤成本的最大部分，而会诊成本（44.7%）占最小部分。总之，我们建议，尽管大多数医生意识到创伤中的成本因素，但他们在诊断和管理中并未考虑创伤成本。
