Hickson G B, Stewart D W, Altemeier W A, Perrin J M
Department of Pediatrics, Vanderbilt University, Nashville, Tennessee 37232.
Pediatrics. 1988 Mar;81(3):333-8.
To investigate the process by which families identified and selected their children's current physicians, a close-ended questionnaire was administered to 750 families in a mail panel. Of 630 responses (84.0%), 244 had children in the home; 229 (93.9%) identified a regular and current physician for their youngest child. However, parents did not spend much time or energy selecting a physician and rarely explored medical expertise in their decisions. Families averaged 1.2 sources of information consulted per decision; few considered more than two physician choices and infrequently considered alternative types of doctors (pediatricians v family or general practitioners). Selection priorities ranked in order of importance concerned parents' perceptions of their doctors' communication skills, accessibility, and quality as determined by recommendations of friends or physicians. Parents appeared less concerned with issues of cost and convenience. Families selecting pediatricians differed from those selecting family and general practitioners in sources of information used and selection priorities. The survey also identified 84 families who had changed or seriously considered changing the physician who was caring for their youngest child. The most frequent dissatisfaction was the perception that an illness was not being managed adequately, followed by believing that the doctor or staff were rude or unconcerned. Families unhappy with pediatricians expressed different reasons from those unhappy with family or general practitioners. The study results provide insight about the first step in obtaining child health care services, a relatively unexplored area of patient decision making.
为了调查家庭识别和选择其子女当前医生的过程，我们向一个邮件小组中的750个家庭发放了一份封闭式问卷。在630份回复（84.0%）中，有244个家庭家中有孩子；其中229个家庭（93.9%）为他们最小的孩子确定了一位常规的现任医生。然而，家长们在选择医生时并没有花费太多时间或精力，并且在做决定时很少探究医生的专业知识。每个决定家庭平均咨询1.2个信息来源；很少有人考虑超过两个医生选择，也很少考虑其他类型的医生（儿科医生与家庭医生或全科医生）。按照重要性排序的选择优先级涉及家长对医生沟通技巧、可及性以及由朋友或医生推荐所决定的质量的看法。家长似乎不太关心费用和便利性问题。选择儿科医生的家庭与选择家庭医生和全科医生的家庭在信息来源和选择优先级方面存在差异。该调查还识别出84个家庭，他们已经更换或认真考虑更换正在照顾其最小孩子的医生。最常见的不满是认为疾病没有得到充分治疗，其次是认为医生或工作人员粗鲁或冷漠。对儿科医生不满意的家庭表达的原因与对家庭医生或全科医生不满意的家庭不同。研究结果为获取儿童医疗服务的第一步提供了见解，这是患者决策中一个相对未被探索的领域。
