Leslie L K, Sarah R, Palfrey J S
Children's Hospital, San Diego, USA.
Pediatrics. 1998 Apr;101(4 Pt 2):746-51; discussion 751-2.
Unprecedented transformations in the financing and organization of child health care are driving change in the practice of pediatrics at a remarkably fast pace. The health care needs of children also are evolving, reflecting changing disease patterns, new technologies, and shifting socioeconomic and demographic characteristics of children and families. Changes in the financing and organization of child health services catalyzed by managed care and legislative initiatives need to be responded to proactively by the pediatric community. Yet, the anticipated health care needs of children also must be addressed as models for both pediatric training and practice in the future are developed. This article summarizes briefly these changes in health care services and in child health needs, addresses training implications, and discusses several initiatives the pediatric community is undertaking to develop guidelines for training pediatricians for the 21st century.
儿童保健融资与组织方面前所未有的变革正以前所未有的速度推动着儿科学实践的变化。儿童的医疗保健需求也在不断演变，反映出疾病模式的变化、新技术以及儿童和家庭社会经济与人口特征的转变。由管理式医疗和立法举措催化的儿童健康服务融资与组织方面的变化，儿科界需要积极应对。然而，在制定未来儿科培训和实践模式时，也必须考虑儿童预期的医疗保健需求。本文简要总结了医疗保健服务和儿童健康需求方面的这些变化，探讨了培训方面的影响，并讨论了儿科界为制定21世纪儿科医生培训指南而开展的多项举措。
