Lind Allison, Latz Kevin, Sinclair Mark R, Williams David D
Children's Mercy Hospital, Division of Orthopaedics and Sports Medicine.
Children's Mercy Hospital, Health Services and Outcomes Research, Kansas City, MO.
J Pediatr Orthop. 2018 Feb;38(2):e33-e37. doi: 10.1097/BPO.0000000000001099.
To examine the current trends in trauma call coverage of pediatric orthopaedic surgeons in North America and to identify predictors of surgeon on-call satisfaction.
In 2015, ∼1200 active members of the Pediatric Orthopaedic Society of North America (POSNA) were surveyed regarding emergency room on-call practices. In total, 410 members completed the survey with a response rate of 35%. Information collected included call frequency, practice setting and satisfaction with call. This information was analyzed and compared with the 2006 and 2010 trauma call surveys of Pediatric Orthopaedic Society of North America membership using 2 sample difference in proportion, χ tests for trend and the Fisher exact tests. Logistic regression analyses were used to identify predictors of call satisfaction among pediatric orthopaedic surgeons.
In total, 47% of pediatric orthopaedic surgeons had access to a designated trauma operating room in 2015, up from 39% in 2010 and 24% in 2006. In total, 43% of pediatric orthopaedic surgeons currently receive a stipend for taking call, up from 35% in 2010 and 28% in 2006. Although 83% of pediatric orthopaedic surgeons believe that trauma call is an integral part of their practice, only 53% are satisfied with their call experience. Controlling for covariates, believing that call is integral to one's practice doubles odds of call satisfaction. Having resident or fellow support and being financially compensated for orthopaedic trauma call also increases one's odds of satisfaction. The odds of being satisfied with call decrease by 7% for each year of increase in age of the surgeon.
Access to a designated trauma operating room and financial compensation for call coverage have steadily increased over the past decade. A sizable majority of respondents continue to believe that trauma care is an integral part of being a pediatric orthopedist. Despite this, 47% of respondents remain dissatisfied with their trauma call arrangements. The age and attitude of the individual surgeon and extent of hospital support predict satisfaction of surgeons providing trauma coverage.
Level V-economic and decision analysis.
研究北美小儿骨科医生创伤呼叫覆盖的当前趋势，并确定值班医生满意度的预测因素。
2015年，对北美小儿骨科学会（POSNA）约1200名活跃会员进行了关于急诊室值班情况的调查。共有410名会员完成了调查，回复率为35%。收集的信息包括呼叫频率、执业环境和对值班的满意度。使用两样本比例差异、趋势χ检验和Fisher精确检验对这些信息进行分析，并与北美小儿骨科学会会员2006年和2010年的创伤呼叫调查进行比较。采用逻辑回归分析确定小儿骨科医生值班满意度的预测因素。
2015年，共有47%的小儿骨科医生可使用指定的创伤手术室，高于2010年的39%和2006年的24%。目前，共有43%的小儿骨科医生因值班获得津贴，高于2010年的35%和2006年的28%。尽管83%的小儿骨科医生认为创伤呼叫是其执业的一个组成部分，但只有53%的人对其值班经历感到满意。在控制协变量的情况下，认为值班是个人执业不可或缺的一部分会使值班满意度的几率翻倍。有住院医师或研究员的支持以及因骨科创伤呼叫获得经济补偿也会增加满意度几率。外科医生年龄每增加一岁，对值班感到满意的几率就会降低7%。
在过去十年中，使用指定创伤手术室的机会和值班覆盖的经济补偿稳步增加。绝大多数受访者仍然认为创伤护理是小儿骨科医生执业不可或缺的一部分。尽管如此，47%的受访者对其创伤呼叫安排仍不满意。个体外科医生的年龄和态度以及医院支持程度可预测提供创伤覆盖的外科医生的满意度。
V级——经济和决策分析。
