Starfield B, Hoekelman R A, McCormick M, Benson P, Mendenhall R C, Moynihan C, Radecki S
Pediatrics. 1984 Dec;74(6):991-7.
Face-to-face visits by children and adolescents in office-based practice in the mid-1970s were studied. Pediatricians, family physicians, and general practitioners accounted for 35%, 6%, and 30%, respectively, of all child visits. Although 40% to 45% of preventive and medical encounters were with pediatricians, only 12% of visits for minor surgery, 20% of visits for psychosocial problems, and 9% of visits for combined medical-surgical reasons were to pediatricians. Only in very young children did pediatricians provide a substantial proportion of care for each of the types of visits. For some common diagnoses (acne, refractive error) most care was provided by specialists other than primary care specialists, but less than 16% of all preventive care visits (including routine eye examinations) was provided by specialists other than primary care physicians. A substantial proportion of the prenatal care and management of minor trauma was provided by family physicians and general practitioners. Although the limitations of the study (including an average response rate of 55%, exclusion of certain specialties and institutional physicians, sampling at different times of the year, lack of control for area of location of practice, and lack of information about response rates of different types of physicians within each specialty) preclude definitive conclusions, the findings raise important questions for future study.
对20世纪70年代中期在门诊进行的儿童和青少年面对面就诊情况进行了研究。儿科医生、家庭医生和全科医生分别占所有儿童就诊的35%、6%和30%。尽管40%至45%的预防和医疗就诊是与儿科医生进行的，但只有12%的小手术就诊、20%的心理社会问题就诊以及9%的综合医疗 - 手术原因就诊是看儿科医生。只有在非常年幼的儿童中，儿科医生才在各类就诊中提供了相当比例的护理。对于一些常见诊断（痤疮、屈光不正），大多数护理是由初级保健专科医生以外的专科医生提供的，但所有预防保健就诊（包括常规眼科检查）中，由初级保健医生以外的专科医生提供的不到16%。家庭医生和全科医生提供了相当比例的产前护理和小创伤处理。尽管该研究存在局限性（包括平均回复率为55%、排除某些专科和机构医生、在一年中的不同时间抽样、缺乏对执业地区的控制以及缺乏每个专科内不同类型医生回复率的信息），无法得出确定性结论，但这些发现为未来研究提出了重要问题。
