Kahn L, Wirth P, Turner J K
Pediatrics. 1977 Jan;59(1):69-72.
A time-and-motion study was performed of a pediatrician's activities in his fee-for-service solo practice and again after he joined a prepaid group practice. A comparison was made between time spent with fee patients in solo practice and time spent with fee patients continuing to see him in group practice. Total time per patient visit was not changed significantly by the group setting. Activities within the visit were modified in the group setting. History-taking and physical examination were reduced; counseling and charting were increased. Time spent in well-child visits in the group setting was significantly longer with the increased time spent in counseling. For sick visits there was no change in total time per visit nor in activities within the visit.
对一位儿科医生在按服务收费的单人执业中的活动进行了一项时间与动作研究，在他加入预付费团体执业后又进行了一次研究。对在单人执业中与按服务收费患者相处的时间和在团体执业中继续找他看病的按服务收费患者相处的时间进行了比较。团体执业环境并未使每次患者就诊的总时间发生显著变化。在团体执业环境中，就诊期间的活动有所改变。病史采集和体格检查时间减少；咨询和记录时间增加。在团体执业环境中，健康儿童就诊的时间因咨询时间增加而显著延长。对于患病就诊，每次就诊的总时间以及就诊期间的活动均无变化。
