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儿童中毒病例暴露对医生行为反应的影响:质量和成本影响

Impact of case exposures on physician behavior responses in childhood poisoning: quality and cost implications.

作者信息

Bharwani Sulaiman, Raheel Hina, Rahim Mehreen, Shaukat Qudsia, Al Hamad Sania, Khan Hasiat

机构信息

From the Departments of *Pediatrics, College of Medicine; †Gynecology and Obstetrics, College of Medicine; ‡Family Medicine, College of Medicine, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates; §Child Health Institute, Al Ain Hospital Affiliate of Vienna Medical University, Vienna, Austria; and ∥Department of Emergency Medicine, Tawam Affiliate of Johns Hopkins International Hospitals, Al Ain, Abu Dhabi, United Arab Emirates.

出版信息

Pediatr Emerg Care. 2013 Dec;29(12):1255-9. doi: 10.1097/PEC.0000000000000023.

Abstract

OBJECTIVES

When measuring physicians' competencies, there is no consensus as to what would constitute an optimum exposure in unintentional pediatric poisoning. In the absence of universal protocols and poison centers' support, the behavior responses of the physicians can vary depending on their exposure to cases. We sought to determine if there was a correlation between the case exposure and physicians' behavior choices that could affect quality and cost of care.

METHODS

A cross-sectional study was conducted in 2010, and a self-reporting survey questionnaire was given to the physicians in the pediatric emergency departments and primary care centers in the city of Al Ain. The physicians' responses were plotted against (a) the number of cases the physicians have had managed in the preceding 12 months and (b) the number of years the physicians have had been in practice

RESULTS

One hundred seven physicians partook in the survey. We found that the physicians who had managed more than 2 cases of childhood poisoning in the preceding year chose significantly more positive behavior responses when compared with those who had managed 2 cases or less. There was no significant difference when the responses were measured against the physicians' number of years of practice.

CONCLUSIONS

Physicians' practice effectiveness may improve if they manage at least 3 cases of childhood poisoning in a year. Physicians training modules could be developed for those physicians who do not get the optimum exposure necessary in improving physicians' behaviors associated with effective quality and cost efficiency.

摘要

目的

在衡量医生的能力时,对于在儿童意外中毒方面何种程度的接触量可构成最佳接触量,尚无共识。在缺乏通用方案和中毒控制中心支持的情况下,医生的行为反应可能因其接触病例的情况而有所不同。我们试图确定病例接触量与医生可能影响医疗质量和成本的行为选择之间是否存在关联。

方法

2010年进行了一项横断面研究,向艾因市儿科急诊科和初级保健中心的医生发放了一份自我报告调查问卷。将医生的回答与(a)医生在过去12个月中处理的病例数以及(b)医生的从业年限进行对比分析。

结果

107名医生参与了调查。我们发现,与处理过2例或更少儿童中毒病例的医生相比,前一年处理过2例以上儿童中毒病例的医生选择的积极行为反应明显更多。根据医生的从业年限衡量回答时,没有显著差异。

结论

如果医生一年至少处理3例儿童中毒病例,其医疗实践效果可能会提高。对于那些没有获得改善与有效质量和成本效益相关的医生行为所需最佳接触量的医生,可以制定培训模块。

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