Cherkin D C, Rosenblatt R A, Hart L G, Schneeweiss R, LoGerfo J
Department of Family Medicine, School of Medicine, University of Washington, Seattle.
Med Care. 1987 Jun;25(6):455-69. doi: 10.1097/00005650-198706000-00001.
This study compared the use of medical resources by recently trained family physicians and general internists. Analyses are based on records of 3,737 adult office encounters with 132 family physicians and 2,250 adult office encounters with 102 general internists. General internists are twice as likely as family physicians to order blood tests, blood counts, chest x-rays, and electrocardiograms for their adult patients. Internists also spend more time with patients, and refer and hospitalize them at slightly higher rates. The different practice styles of general internists and family physicians were evident for adult patients of all ages and for patients with essential benign hypertension. The average per visit charge for diagnostic tests ordered during follow-up visits with hypertensive patients was estimated to be $11.97 for patients seen by general internists and $5.67 for patients seen by family physicians. These findings persisted after controlling for a variety of patient, practice, and physician characteristics.
本研究比较了近期培训的家庭医生和普通内科医生对医疗资源的使用情况。分析基于132名家庭医生的3737例成人门诊记录以及102名普通内科医生的2250例成人门诊记录。普通内科医生为成年患者开具血液检查、血细胞计数、胸部X光和心电图检查的可能性是家庭医生的两倍。内科医生与患者相处的时间也更长，转诊和住院率略高。普通内科医生和家庭医生不同的行医方式在各年龄段的成年患者以及原发性良性高血压患者中都很明显。随访高血压患者时，普通内科医生为患者开出的诊断检查每次平均费用估计为11.97美元，家庭医生为患者开出的诊断检查每次平均费用为5.67美元。在控制了各种患者、行医和医生特征后，这些发现依然存在。
