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  1. The generalist role of specialty physicians : Is there a hidden system of primary care ?

    Article - En anglais

    Context-Despite increased emphasise on primary care in the United States, most care continues to be provided by specialists.

    The extent to which specialists incorporate elements of primary care in their approach to ambulatory patients is unknown.

    Objectives

    - To examine the extent to which selected medical and surgical subspecialties provide generalist care to Medicare patients, and to compare patterns of care between specialists and generalists.

    Design

    - A cross-sectional study of all ambulatory care recorded in Part B of the Washington State Medicare Claims Database in 1994 and 1995.

    Setting

    - Ambulatory practices in Washington State.

    Patients

    - Medicate benefidaries 65 years or older who made office visits to the study physicians.

    Main Outcome Measures

    - The extent to which individual specialties accounted for the majority of visits made by patients to physicians (a measure of continuity), provided care-outside the traditional domain of their specialty (a measure of comprehensiveness), and provided influenza immunization.

    Results

    - A total of 373 505 patients constituted the sample.

    Patients had an average of 7.48 outpatient visits per year ; 9.6% saw only generalists, while 14.7% saw only specialists.

    The practices of general intemists and family physicians differ systematically from the practices of most specialists.

    Approximately half (49. (...)

    Mots-clés Pascal : Médecin généraliste, Etats Unis, Amérique du Nord, Amérique, Soin santé primaire, Service santé, Ambulatoire, Spécialité médicale, Rôle professionnel, Agent santé, Etude comparative, Vieillard, Homme, Medicare

    Mots-clés Pascal anglais : General practitioner, United States, North America, America, Primary health care, Health service, Ambulatory, Medical specialty, Occupational role, Health worker, Comparative study, Elderly, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0261408

    Code Inist : 002B30A05. Création : 11/09/1998.