Agrawal Rishi, Shah Parag, Zebracki Kathy, Sanabria Kathy, Kohrman Claire, Kohrman Arthur F
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Clin Pediatr (Phila). 2012 Jan;51(1):39-45. doi: 10.1177/0009922811417288. Epub 2011 Aug 19.
OBJECTIVE. To assess primary care pediatricians' (PCPs') perceptions of caring for children and youth with special health care needs (CYSHCN). METHODS. Cross-sectional survey of Illinois pediatricians. RESULTS. Thirty-five percent of surveys were returned and 26% were analyzed. The top 3 perceived barriers were insufficient time (72%), insufficient reimbursement (68%), and lack of support services (59%). Insufficient interest was the least cited barrier (19%). Preparedness to perform tasks related to care of CYSHCN ranged from 89% for accessing early intervention services to 24% for billing and coding. The percentage of PCPs somewhat or very comfortable providing primary care to patients with technology dependence ranged from 75% for blood glucose monitoring to 12% for dialysis. CONCLUSIONS. The issues of time, reimbursement, billing, and coding are perceived as significant barriers to the care CYSHCN. There is substantial variation in PCPs' comfort in the care of CYSHCN who require the assistance of medical technologies.
目的。评估基层儿科医生（PCP）对照顾有特殊医疗需求的儿童和青少年（CYSHCN）的看法。方法。对伊利诺伊州的儿科医生进行横断面调查。结果。35%的调查问卷被收回，26%被分析。排在前三位的感知障碍是时间不足（72%）、报销不足（68%）和缺乏支持服务（59%）。兴趣不足是被提及最少的障碍（19%）。执行与CYSHCN护理相关任务的准备程度从获取早期干预服务的89%到计费和编码的24%不等。对技术依赖患者提供初级护理感到 somewhat或非常舒适的PCP百分比，从血糖监测的75%到透析的12%不等。结论。时间、报销、计费和编码问题被视为CYSHCN护理的重大障碍。PCP在照顾需要医疗技术协助的CYSHCN时的舒适度存在很大差异。
