Adelman A M, Fredman L, Knight A L
Department of Family and Community Medicine, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey 17033-0805.
J Fam Pract. 1994 Jul;39(1):39-44.
There has been no national survey of physician house calls since 1980, and in particular, no survey of pediatric house calls in 30 years. This national study was undertaken to compare physician house call practices among family physicians, general internists, and general pediatricians.
A mail survey was conducted of 1500 primary care physicians who were randomly selected from the American Medical Association Physician Master File. Five hundred physicians were selected from each of three specialties: family medicine, internal medicine, and pediatrics.
Nine hundred six questionnaires were returned for a response rate of 59%. The percentage of family physicians making house calls was significantly greater than that of internists or pediatricians (63%, 47%, and 15%, respectively). Factors associated with making house calls were: house calls being a common practice in the community, solo practice, specialty (family practice), sex (male), and practice location in the northeast. Physicians who agreed with the following attitudes were more likely to make house calls: (1) making house calls leads to high patient satisfaction; (2) house calls are important for good comprehensive patient care; and (3) house calls are satisfying for physicians. Physicians who agreed that making house calls exposes them to a significant malpractice risk were half as likely to make house calls.
Family physicians made significantly more house calls than internists or pediatricians.
自1980年以来,尚未进行过全国性的医生上门问诊调查,尤其是30年来未曾有过儿科上门问诊的调查。这项全国性研究旨在比较家庭医生、普通内科医生和普通儿科医生的上门问诊做法。
对从美国医学协会医生主档案中随机抽取的1500名初级保健医生进行了邮寄调查。从家庭医学、内科和儿科这三个专业中各选取了500名医生。
共收回906份问卷,回复率为59%。进行上门问诊的家庭医生比例显著高于内科医生或儿科医生(分别为63%、47%和15%)。与上门问诊相关的因素包括:上门问诊在社区中是常见做法、个体执业、专业(家庭医学)、性别(男性)以及在东北部的执业地点。认同以下态度的医生更有可能进行上门问诊:(1)上门问诊能带来较高的患者满意度;(2)上门问诊对提供良好的全面患者护理很重要;(3)上门问诊让医生感到满意。认为上门问诊会使他们面临重大医疗事故风险的医生进行上门问诊的可能性只有一半。
家庭医生进行的上门问诊显著多于内科医生或儿科医生。