Grimm R H, Shimoni K, Harlan W R, Estes E H
N Engl J Med. 1975 Mar 6;292(10):507-11. doi: 10.1056/NEJM197503062921005.
A symptom-oriented protocol for acute pharyngitis was evaluated in a busy general medical clinic staffed by physicians and graduate and student physician's assistants. We observed significantly improved performance by all providers in collection of medical data, utilization of laboratory tests,and appropriate use of antibiotics after introduction of the protocol. Patient charges were less when the protocol was used, but these savings were offset partially by the cost of audit. Compliance with and acceptance of the protocol differed among the various health providers, with physicians demonstrating significantly lower levels than nonphysicians. Patient-care protocols provide an effective means of monitoring the process of medical care, detecting weakness in supportive clinic services, and affording educational feedback for all health providers.
在一家由医生、研究生和学生医师助理组成的繁忙普通内科诊所中，对一种针对急性咽炎的症状导向型方案进行了评估。在引入该方案后，我们观察到所有医疗服务提供者在收集医疗数据、使用实验室检查以及合理使用抗生素方面的表现都有显著改善。使用该方案时患者费用较低，但这些节省部分被审计成本所抵消。不同医疗服务提供者对该方案的依从性和接受程度有所不同，医生的依从性和接受程度明显低于非医生。患者护理方案提供了一种有效的手段，可用于监测医疗护理过程、发现支持性门诊服务中的薄弱环节，并为所有医疗服务提供者提供教育反馈。
