Comparing Patients Seen in Pediatric Resident Continuity Clinics and National Ambulatory Medical Care Survey Practices: A Study From the Continuity Research Network

OBJECTIVES. The goal was to compare visit data from Continuity Research Network practices with data for a nationally representative sample of pediatric visits in practice settings from the National Ambulatory Medical Care Survey. METHODS. A cross-sectional study comparing data for Continuity Research Network practice visits during a 1-week period in 2002 with data from the 2000 National Ambulatory Medical Care Survey was performed. Continuity Research Network and National Ambulatory Medical Care Survey data were derived from 30 patient visits per practice site for patients <22 years of age, with the primary care providers being residents and practicing pediatricians, respectively. RESULTS. Eighteen Continuity Research Network practices reported on 540 visits, compared with 32 National Ambulatory Medical Care Survey physicians reporting on 792 visits. Continuity Research Network patients were more likely to be black non-Hispanic or Hispanic/Latino and to have public insurance. The top 5 reasons for visits were the same for Continuity Research Network and National Ambulatory Medical Care Survey visits, although the orders varied slightly. These 5 reasons accounted for 58% of Continuity Research Network visits and 49% of National Ambulatory Medical Care Survey visits. Continuity Research Network visits were more likely to result in patient instructions to return at a specific time (78% vs 52%). CONCLUSIONS. Residents in Continuity Research Network practices provide care to more underserved patients but evaluate problems that are similar to those observed in office practices; the Continuity Research Network practices thus provide important training experiences for residents who will serve both minority and nonminority children.

[1]  Yuji Saruta,et al.  The state of , 2005 .

[2]  B. Zuckerman,et al.  Prevalence and Correlates of High-Quality Basic Pediatric Preventive Care , 2004, Pediatrics.

[3]  Margaret C Fang,et al.  Are patients more likely to see physicians of the same sex? Recent national trends in primary care medicine. , 2004, The American journal of medicine.

[4]  P. Darden,et al.  Time in Continuity Clinic as a Predictor of Continuity of Care for Pediatric Residents , 2004, Pediatrics.

[5]  T. Sectish,et al.  The State of Pediatrics Residency Training: A Period of Transformation of Graduate Medical Education , 2004, Pediatrics.

[6]  K. Pearce,et al.  How and Why to Study the Practice Content of a Practice-Based Research Network , 2004, The Annals of Family Medicine.

[7]  D. Cherry,et al.  National Ambulatory Medical Care Survey: 2002 summary. , 2004, Advance data.

[8]  S. Flocke,et al.  A Comparison of the National Ambulatory Medical Care Survey (NAMCS) Measurement Approach With Direct Observation of Outpatient Visits , 2004, Medical care.

[9]  K. Edwards,et al.  Differences in antibiotic prescribing patterns for children younger than five years in the three major outpatient settings. , 2004, The Journal of pediatrics.

[10]  Glenn Flores,et al.  Keeping children out of hospitals: parents' and physicians' perspectives on how pediatric hospitalizations for ambulatory care-sensitive conditions can be avoided. , 2003, Pediatrics.

[11]  P. Young,et al.  How well does the continuity experience prepare residents for practice? , 2002, Ambulatory Pediatrics.

[12]  D. Cherry,et al.  National Ambulatory Medical Care Survey: 2000 summary. , 2002, Advance data.

[13]  P. Darden,et al.  Comparison of continuity in a resident versus private practice. , 2001, Pediatrics.

[14]  J. Serwint Multisite survey of pediatric residents' continuity experiences: their perceptions of the clinical and educational opportunities. , 2001, Pediatrics.

[15]  J. Leventhal,et al.  Care to Underserved Children: Residents' Attitudes and Experiences , 2000, Pediatrics.

[16]  P. Jensen,et al.  Medication Management of Stimulants in Pediatric Practice Settings: A National Perspective , 2000, Journal of developmental and behavioral pediatrics : JDBP.

[17]  R. Wasserman,et al.  Pediatric research in office settings (PROS): a national practice-based research network to improve children's health care. , 1998, Pediatrics.

[18]  P. Auinger,et al.  Resident and Family Continuity in Pediatric Continuity Clinic: Nine Years of Observation , 1998, Pediatrics.

[19]  T. Dewitt,et al.  Caveat emptor? Caveat lector (reader beware)! , 1997, Archives of Pediatrics & Adolescent Medicine.

[20]  J. Drutz,et al.  Comparison of continuity clinic experience by practice setting and postgraduate level. , 1996, Archives of pediatrics & adolescent medicine.

[21]  L. Osborn,et al.  Effects of time-in-clinic, clinic setting, and faculty supervision on the continuity clinic experience. , 1993, Pediatrics.

[22]  X Tonesk,et al.  Implementing clinical practice guidelines: social influence strategies and practitioner behavior change. , 1992, QRB. Quality review bulletin.

[23]  J. Eisenberg Sociologic influences on decision-making by clinicians. , 1979, Annals of internal medicine.

[24]  J. Serwint,et al.  Factors associated with resident satisfaction with their continuity experience. , 2004, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[25]  J. Klein,et al.  Male adolescent use of health care services: where are the boys? , 2002, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[26]  P. Auinger,et al.  Children in big cities in the United States: Health and related needs and services , 1996 .