Children Attending Paediatricians Study: a national prospective audit of outpatient practice from the Australian Paediatric Research Network

被引:62
|
作者
Hiscock, Harriet [1 ,2 ,3 ]
Roberts, Gehan [1 ,2 ,3 ]
Efron, Daryl [1 ,2 ,3 ]
Sewell, Jillian R. [1 ,2 ,3 ]
Bryson, Hannah E. [1 ,2 ]
Price, Anna M. H. [1 ,2 ]
Oberklaid, Frank [1 ,2 ,3 ]
South, Michael [1 ,2 ,3 ]
Wake, Melissa A. [1 ,2 ,3 ]
机构
[1] Royal Childrens Hosp, Melbourne, Vic, Australia
[2] Murdoch Childrens Res Inst, Ctr Community Child Hlth, Melbourne, Vic, Australia
[3] Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia
基金
英国医学研究理事会;
关键词
MEDICAL-CARE; OFFICE SETTINGS; HEALTH; ECOLOGY;
D O I
10.5694/j.1326-5377.2011.tb03028.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To audit general paediatric outpatient practice in Australia, including consultation characteristics and management patterns, diagnoses, factors associated with diagnoses, and billing practices. Design, setting and participants: In October-November 2008, members of the Australian Paediatric Research Network (APRN; a national network of paediatricians established to facilitate multisite secondary care research) were invited to prospectively complete brief standardised data collection forms for 100 consecutive patients or all patients during a 2-week period, whichever came first. Main outcome measures: Length of consultation and type of diagnoses made; proportions recorded as having medications, investigations or referral; odds ratios for factors associated with diagnoses; and proportions of Medicare items billed. Results: Of 300 APRN members, 199 (66%) completed data forms for 8345 consultations in which 15 375 diagnoses were made (mean, 1.8 diagnoses per consultation); 46.0%, 30.9% and 22.8% of consultations involved 1, 2 and >= 3 diagnoses, respectively. New and review consultations lasted a mean of 41 (SD, 20) and 26 (SD, 15) minutes, respectively. The most common diagnoses were attention deficit hyperactivity disorder (18.3%), baby checks (9.1%), and learning difficulties (7.5%). Patients seen in 47.5% of consultations had medications (eg, prescriptions, vaccinations) recorded, and patients in 27.2% of consultations were referred elsewhere, usually to a subspecialist or psychologist (31.6% and 26.6% of referrals, respectively). Male sex of the child and owning a Health Care Card were associated with most developmental behavioural diagnoses. Paediatricians tended to bill for single disease/non-complex consultations, even when seeing a child with multiple problems. Conclusions: Australian paediatricians see children with a range of diagnoses that are often multiple and complex. Our findings provide directions for future secondary care research, and may inform workforce planning and paediatricians' training requirements. MJA 2011; 194: 392-397
引用
收藏
页码:392 / 397
页数:6
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