Abstract:
:Pediatrician reimbursement is shifting from fee-for-service to a fixed salary. In the Netherlands, as physicians working on a fee-for-service basis have a financial interest in talking less and in carrying out more diagnostic tests and investigations, it may be questioned whether this will influence the structure and content of medical visits. With use of 302 videotaped outpatient encounters with either salaried or fee-for-service pediatricians, differences were examined in visit length, number of requests for diagnostic tests and investigations (laboratory test, endoscopy, and radiography), pediatrician-parent communication behaviors, and patient satisfaction. This investigation was carried out by means of bivariate and multilevel analysis. The results showed that the visits with salaried pediatricians lasted almost 4 minutes longer. This surplus time was not spent on social talk or on a more elaborate history taking but was used to provide more information and advice. In addition, salaried pediatricians engaged in more empathic behavior toward the patient, thereby facilitating a therapeutic relationship. No differences were found in the number of diagnostic tests and investigations or in patient satisfaction. It may be concluded that history taking and social talk took place in a fixed part of the visit. Salaried pediatricians spent more time on exchanging information with their patients and paid more attention to patient concerns and emotions. As the reimbursement shift is not likely to diminish the number of diagnostic tests and investigations and will increase the length of the medical visits, overall financial benefits may be limited.
journal_name
Clin Pediatr (Phila)journal_title
Clinical pediatricsauthors
van Dulmen AMdoi
10.1177/000992280003901004subject
Has Abstractpub_date
2000-10-01 00:00:00pages
591-601issue
10eissn
0009-9228issn
1938-2707journal_volume
39pub_type
杂志文章abstract::Knowledge of the characteristics of family structure may be helpful to the pediatrician for predicting child abuse. During the past several decades progressive shifts from the classic family unit of two biological parents and their children to a variety of parental living arrangements have occurred. Most notable are t...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992280604500201
更新日期:2006-03-01 00:00:00
abstract::Child psychiatric consultants perform psychiatric assessment and liaison among various clinical services. Execution of these familiar roles for pediatric liver transplantation recipients exposes unfamiliar and difficult bioethical problems. Administrative problems arise if the recipient's suitability is too narrowly e...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702600207
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:To describe parents' and adolescents' perceptions about vaccination. METHODS:Qualitative interviews of 22 mothers/grandmothers and 25 10- to 14-year-olds. RESULTS:Themes emerged in 3 focus areas. (a) Understanding: Both adults and adolescents had difficulty understanding concepts of risks, benefits, prevent...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809351091
更新日期:2010-04-01 00:00:00
abstract::For 'Factors Associated With Specific Language Impairment and Later Language Development During Early Life: A Literature Review' by Benjamas Prathanee, MA, Bandit Thinkhamrop, PhD, Sumalee Dechongkit, PhD; Clinical Pediatrics; Volume 46 Number 1, January 2007; 22-29; © 2007; SAGE Publications; 10.1177/0009922806297153...
journal_title:Clinical pediatrics
pub_type: 杂志文章,已发布勘误
doi:10.1177/0009922817720961
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Ethanol lock therapy (ELT) with systemic antimicrobial therapy is a promising therapy for catheter-related infection (CRI). The impact of ELT timing on treatment efficacy and costs is unknown. PROCEDURES:A prospective study was conducted in the Hematology/Oncology Unit at the Children's Hospital of Michigan...
journal_title:Clinical pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1177/0009922817717327
更新日期:2018-03-01 00:00:00
abstract::Pediatricians are expected to discuss the hazards of passive smoking and provide smoking cessation counseling (SCC) because passive smoking is known to have a direct negative effect on children's health. We conducted a cross-sectional survey of pediatric and medicine- pediatric residents at 2 training programs to iden...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922807308182
更新日期:2008-04-01 00:00:00
abstract::Falszewska A, Dziechciarz P, Szajewska H. The diagnostic accuracy of Clinical Dehydration Scale in identifying dehydration in children with acute gastroenteritis: a systematic review. Clin Pediatr (Phila). 2014;53:1181-8. (Original DOI: 10.1177/0009922814538493 ). ...
journal_title:Clinical pediatrics
pub_type: 杂志文章,已发布勘误
doi:10.1177/0009922817711992
更新日期:2018-01-01 00:00:00
abstract::With discouragingly low vaccination rates for human papillomavirus (HPV), we sought to improve the HPV vaccine completion rate for adolescents by increasing the consistency and quality of provider recommendations. Baseline data was extracted for vaccine completion rates among patients aged 13 to 17 years. Quality impr...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922817722014
更新日期:2018-03-01 00:00:00
abstract::During 1981, we treated 20 infants, less than 24 months old, for nontyphoid Salmonella (NTSal) gastroenteritis (GE). Blood cultures were obtained in 17 cases, and Salmonella bacteremia was demonstrated in 8 (47%). Of the 13 children 3 to 24 months of age, 7 (54%) had positive blood cultures. One child (8 months old) a...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288302200901
更新日期:1983-09-01 00:00:00
abstract::Although trauma undertriage has been widely discussed in the literature, undertriage in the pediatric trauma population remains understudied. Using the 2009-2013 Nationwide Emergency Department Sample, we assessed the national undertriage rate in pediatric major trauma patients (age ≤16 years and injury severity score...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922817709553
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To assess weight stigma, self-perception of weight status, and factors contributing to accurate self-perception of weight status in obese youth presenting for treatment at a hospital-based multidisciplinary weight management program. METHODS:Participants (N = 97; mean age = 8.56 +/- 1.66 years) used a figura...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809346571
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:Intervention to reduce nonurgent pediatric emergency department (PED) visits over a 12-month follow-up. METHODS:Prospective, randomized, controlled trial enrolled children seen in the PED for nonurgent concerns. Intervention subjects received a structured session/handout specific to their primary care provid...
journal_title:Clinical pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1177/0009922814540987
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To compare parental report of child body image with perceived healthy weight body image in preschoolers and describe weight-counseling preferences. METHODS:Parents seeking well-child care were interviewed and asked to select images resembling: (a) their own child's current weight, (b) a healthy weight presch...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922810368288
更新日期:2010-08-01 00:00:00
abstract::Patients with selective IgA deficiency, the most common primary immunodeficiency, occasionally may undergo spontaneous recovery. In this paper we present three additional children whose IgA levels spontaneously returned to normal. All three presented with gastrointestinal symptoms, and one child also had frequent uppe...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288202100202
更新日期:1982-02-01 00:00:00
abstract::A method for the detection of bacterial pathogens in sepsis and bacterial meningitis with 16S rRNA gene- based real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) is developed. A total of 190 blood specimens and 5 cerebrospinal fluid specimens from neonates with suspected sepsis or bacterial meningit...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809333972
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a major contributor to neonatal hyperbilirubinemia, yet newborn screening for this disorder in the United States is not standard practice. We surveyed pediatric providers regarding a novel newborn G6PD screening program successfully implemented in 2007 at...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922814557786
更新日期:2015-06-01 00:00:00
abstract::Prior studies have found that close mother-child sleep proximity helps increase rates of breastfeeding, and breastfeeding itself is linked to better maternal and infant health. In this study, we examine whether breastfeeding and infant bed-sharing are related to daily rhythms of the stress-responsive hormone cortisol....
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922815601981
更新日期:2016-05-01 00:00:00
abstract::Objectives. The available literature on pulmonary disease in pediatric inflammatory bowel disease is limited. We evaluated the prevalence of pulmonary manifestations in pediatric inflammatory bowel disease and their association with disease severity. Methods. Patients completed the St. George's Respiratory Questionnai...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922820910821
更新日期:2020-06-01 00:00:00
abstract::In this retrospective case series, we report clinical factors associated with pediatric peritonsillar abscess (PTA), with hopes of contributing to the design of an evidenced-based, economic treatment approach. Charts were examined for presenting symptoms and signs. Each of these were analyzed for association with the ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922818778048
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To measure the willingness and ability of primary care pediatricians (PCPs) to accept children and youth with special health care needs (CYSHCN) into their practices. METHODS:Surveys were mailed to 1441 members of the Illinois Chapter of the American Academy of Pediatrics practicing primary care. RESULTS:In...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922813476572
更新日期:2013-04-01 00:00:00
abstract::Presenting characteristics, long-term outcome, and techniques used in the diagnosis of 143 infants with suspected biliary obstruction are reviewed. Sixty-nine patients had surgically confirmed extrahepatic disease and 74 had intrahepatic disorders. A disproportionate number of infants with intrahepatic disease were bo...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288502400601
更新日期:1985-06-01 00:00:00
abstract::An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallowing, in adolescents...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1177/0009922806292792
更新日期:2006-10-01 00:00:00
abstract::Despite recommendations against routine imaging, chest radiography (CXR) is frequently performed on infants hospitalized for bronchiolitis. We conducted a review of 811 infants hospitalized for bronchiolitis to identify clinical factors associated with imaging findings. CXR was performed on 553 (68%) infants either on...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922817698802
更新日期:2017-10-01 00:00:00
abstract::The authors present a report on two sibling with a nearly identical phenotype mimicking peroxisomal disorder but with totally discordant biochemical findings. In an attempt to confirm the diagnosis of a peroxisomal disorder, plasma levels of very long chain fatty acids (VLCFA) and phytanic acid were determined. In add...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900814
更新日期:1990-08-01 00:00:00
abstract::The Danish social system provides competent, accessible, continuous, and coordinated medical care to the pediatric population. The pediatrician does not deal with the routine aspects of well-infant and child care but is rather hospital based and acts on consultant to the generalists in his district. The generalist has...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992287501400409
更新日期:1975-04-01 00:00:00
abstract::A 13-year old boy with acute lymphoblastic leukemia on chemotherapy developed neutropenia and acute cellulitis progressing to fulminating septicemia due to Pseudomonas pseudomallei. Septicemic melioidosis should be considered in the differential diagnosis of a febrile illness in children who are susceptible to infecti...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288001901012
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVE:Dysfunctional voiding (DV) is an extremely common pediatric complaint. The goal of this study was to examine the relationship between DV and childhood temperament. METHODS:Information about the voiding behaviors and temperaments of 50 children was examined using a case-control model. Caregivers were asked to...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922813492376
更新日期:2013-08-01 00:00:00
abstract::Each year, 3.3 to 10 million children are exposed to domestic violence/abuse (DV). Providers' reporting obligations for these children are unclear. The child maltreatment statutes available on state's web sites (through August 2003) were reviewed. Only Alaska defines DV in the presence of a child as child abuse within...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992280404300506
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Benefits associated with probiotic administration to children seeking emergency department care with diarrheal disease are unknown. METHODS:In this 3-site, double-blind, placebo-controlled study, children aged 4 to 48 months with gastroenteritis were randomized to receive 5 days of placebo, low-dose (4 × 10...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1177/0009922815569200
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Control of environmental triggers (ETs) greatly improves asthma outcomes in children. Disseminating these findings to general pediatricians has not been well established. METHODS:After delivering a structured and standardized presentation on ET identification and control to pediatricians, we surveyed them a...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1177/0009922813482752
更新日期:2013-06-01 00:00:00