Klein M
Department of Family Practice, University of British Columbia, Vancouver, Canada.
Prim Care. 1993 Sep;20(3):523-36.
All 17 studies of family practice maternity care have shown reduced procedure rates for comparable populations of women cared for by family physicians versus those cared for by obstetricians, while maternal and infant outcomes are as good or better for the patients of family practitioners. System issues are the most predictive of positive outcomes such that in settings in which continuity and intimacy is high and women of no defined risk are cared for by providers specifically oriented to such care, outcomes are the best. In contrast, when such women are cared for by providers specifically oriented for high-risk or tertiary settings, their care becomes medicalized and they become sick. Staff attitudes, rules, and organizational structures are more predictive of outcome than professional labels. Family physicians in all settings can do more to lower their intervention rates and "humanize" care.
所有17项关于家庭医生产科护理的研究均表明，与由产科医生护理的可比女性群体相比，由家庭医生护理的女性群体的手术率降低，而家庭医生护理的患者的母婴结局同样良好或更佳。系统问题对积极结局的预测性最强，即在连续性和亲密性较高且无明确风险的女性由专门从事此类护理的提供者护理的环境中，结局最佳。相比之下，当此类女性由专门针对高风险或三级护理环境的提供者护理时，她们的护理会变得医学化，她们也会生病。员工态度、规则和组织结构对结局的预测性比专业标签更强。所有环境中的家庭医生都可以在降低干预率和使护理“人性化”方面做得更多。
