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- Title
Educating physicians and treating patients in the ambulatory setting. Where are we going and how will we know when we arrive?
- Authors
Brook, Robert H.; Fink, Arlene; Kosecoff, Jacqueline; Linn, Lawrence S.; Watson, Wendy Everett; Davies, Allyson Ross; Clark, Virginia A.; Kamberg, Caren; DelBanco, Thomas L.; Brook, R H; Fink, A; Kosecoff, J; Linn, L S; Watson, W E; Davies, A R; Clark, V A; Kamberg, C; Delbanco, T L
- Abstract
We evaluated 15 group practices in general internal medicine in university hospitals with regard to access to and quality of care, patients' satisfaction with that care, and quality of residency education provided. We used these data to speculate about potential changes in ambulatory care programs in university teaching hospitals. All 15 practices participated for 4 years. One third of their patient population had no medical insurance. Practice patients had twice as many chronic illnesses as did the general population, and two fifths of patients stayed at least 2 years in the practice. Few faculty members spent more than 14 hours weekly in the practices, and housestaff worked an average of 4 hours per week. Patient waiting times did not meet ideal standards, but patient satisfaction was higher than in a general population. Compliance with quality of care criteria was not exceptional; for example, 10% of eligible patients received an annual influenza vaccination. Housestaff assigned a relatively low ranking to their educational experience in the practices. We recommend the institution of additional experimental programs in ambulatory care and housestaff education to improve the quality of care in the ambulatory setting.
- Subjects
UNITED States; INTERNAL medicine; HOSPITALS; PATIENTS; CARING; ACADEMIC medical centers; COMPARATIVE studies; CONTINUUM of care; GROUP medical practice; HEALTH services accessibility; OUTPATIENT services in hospitals; INTERNSHIP programs; RESEARCH methodology; MEDICAL quality control; MEDICAL cooperation; PRIMARY health care; RESEARCH; EVALUATION research
- Publication
Annals of Internal Medicine, 1987, Vol 107, Issue 3, p392
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-107-2-392