Thompson H C, Osborne C E
Med Care. 1976 Jan;14(1):22-38. doi: 10.1097/00005650-197601000-00003.
This paper reports the opinions of a representative sample of 1,329 physicians providing primary care regarding criteria developed by the Joint Committee on Quality Assurance for evaluation of ambulatory child health care. Areas of care were health supervision (in four age ranges), tonsillopharyngitis, bronchial asthma, and urinary infection. The criteria had been previously appraised by 452 "experts"--academicians and practitioners. Physicians rated criteria for relevance to health outcome, and desirability for use in peer review. They also stated whether they usually performed and recorded each item and gave reasons for not recording. Agreement between the pediatricians and other physicians of the sample and the "experts" was close regarding relevance to health outcome, but many fewer criteria were recommended for peer review by the sample. A significant number of respondents said they performed but did not record many of the criteria. Documentation of only abnormal findings was the main reason given for not recording. Criteria dealing with developmental or behavioral assessment or with counseling were rated lower in all categories than more easily measured items.
本文报告了1329名提供初级保健服务的医生对质量保证联合委员会制定的评估儿童门诊保健标准的代表性样本的看法。保健领域包括健康监督（四个年龄范围）、扁桃体咽炎、支气管哮喘和尿路感染。这些标准此前已由452名“专家”——院士和从业者进行了评估。医生们对标准与健康结果的相关性以及在同行评审中的适用性进行了评分。他们还说明了自己是否通常执行并记录每个项目，并给出未记录的原因。样本中的儿科医生和其他医生与“专家”在与健康结果的相关性方面意见相近，但样本推荐用于同行评审的标准要少得多。相当多的受访者表示，他们执行了许多标准但未记录。只记录异常发现是未记录的主要原因。在所有类别中，涉及发育或行为评估或咨询的标准的评分都低于更容易衡量的项目。
