Hand R, Garg M, Dajani K F
Department of Medicine, University of Illinois College of Medicine at Chicago 60612.
Acad Med. 1993 Oct;68(10):803-5. doi: 10.1097/00001888-199310000-00021.
The authors wished to learn whether the primary ambulatory care clinics of a university hospital had a sufficiently diverse patient mix for training in common medical problems.
Claims data for all the ambulatory care clinics at the University of Illinois Hospital from June 1989 through June 1990 were examined for principal diagnoses. The diagnoses were grouped into common ambulatory care diagnosis clusters. The frequencies of the clusters were compared with the national frequencies from the National Ambulatory Medical Care Survey of 1989.
Only eight of 25 leading clusters nationally were seen with frequencies greater than 1% in the hospital's primary care clinics (i.e., family practice, general internal medicine, general pediatrics). This number increased to 22 when the clinics of other specialties were included.
To create an appropriate patient mix for training medical students and residents in ambulatory care, the university hospital examined in this study could supplement the use of its primary care clinics with the use of clinics in other specialties. This may be a less expensive and administratively less complex alternative to using off-campus private practices for such training.
作者希望了解大学医院的初级门诊护理诊所是否有足够多样化的患者组合，用于常见医疗问题的培训。
对伊利诺伊大学医院1989年6月至1990年6月期间所有门诊护理诊所的索赔数据进行主要诊断检查。将诊断分组为常见的门诊护理诊断集群。将这些集群的频率与1989年国家门诊医疗护理调查的全国频率进行比较。
在全国25个主要集群中，只有8个在该医院的初级保健诊所（即家庭医学、普通内科、普通儿科）中出现的频率超过1%。当纳入其他专科的诊所时，这个数字增加到了22个。
为了创建一个合适的患者组合，用于培训医学生和住院医师的门诊护理，本研究中所考察的大学医院可以通过使用其他专科的诊所来补充其初级保健诊所的使用。对于此类培训而言，这可能是一种比使用校外私人诊所成本更低且管理上不太复杂的替代方案。
