Friedland J A, Wu L, Wray N P
J Med Educ. 1985 Oct;60(10):772-6. doi: 10.1097/00001888-198510000-00004.
A significant portion of internal medicine residency training in the United States today occurs in general medicine sections of Veterans Administration hospitals. The authors studied the demographic, diagnostic, and prognostic characteristics of the patients treated by house staff members rotating through the general medical wards of the Houston, Texas, Veterans Administration (VA) Medical Center. In 2,131 admissions over 13 months, the most frequent primary causes of admissions included congestive heart failure, pneumonia, exacerbation of chronic obstructive lung disease, and malignancy. In 85 percent of the admissions, two or more chronic diseases were present. In 53 percent of admissions, the patients were deemed to be moderately or severely ill on admission. The data indicate that the residents' experience is representative of problems encountered by practicing internists and that VA hospitals make a significant contribution to internal medicine training and thus to the provision of health care for the nation.
如今在美国，很大一部分内科住院医师培训是在退伍军人管理局医院的普通内科部门进行的。作者研究了在得克萨斯州休斯顿退伍军人管理局（VA）医疗中心普通内科病房轮转的住院医师所治疗患者的人口统计学、诊断和预后特征。在13个月内的2131例入院病例中，最常见的主要入院原因包括充血性心力衰竭、肺炎、慢性阻塞性肺疾病加重和恶性肿瘤。在85%的入院病例中，存在两种或更多种慢性疾病。在53%的入院病例中，患者入院时被认为病情为中度或重度。数据表明，住院医师的经历代表了执业内科医生所遇到的问题，并且退伍军人管理局医院对内科培训做出了重大贡献，从而为国家的医疗保健服务做出了贡献。
