Impact of education for physicians on patient outcomes.

Abstract:

OBJECTIVES:This study was conducted to assess the impact of an interactive seminar based on self-regulation theory on 1) the treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' parents. METHODS:A total of 74 general practice pediatricians were assigned to either a program or a control group in a randomized controlled study. Data were collected from physicians at baseline, and 69 (93%) provided follow-up data 5 months after the program. Data were also collected from 637 of their patients at baseline, and in a 22-month window after the intervention, 472 (74%) of this number provided follow-up data. RESULTS:After the seminar, physicians in the program group were more likely than were control group physicians to address patients' fears about medicines, review written instructions, provide a sequence of educational messages, write down how to adjust the medicines at home when symptoms change, and report that they spent less time with their patients. Parents of the children treated by program physicians were significantly more likely than were control group parents to report that the physician had been reassuring, described as a goal that the child be fully active, and gave information to relieve specific worries. After a visit with the physician, these parents were also more likely to report that they knew how to make management decisions at home. After the intervention compared to controls, patients of physicians in the program group were more likely to have received a prescription for inhaled antiinflammatory medicine and to have been asked by the physician to demonstrate how to use a metered-dose inhaler. After the intervention, children seen by program physicians made significantly fewer nonemergency office visits and visits for follow-up of an episode of symptoms; however, there were no differences in emergency department visits and hospitalizations. Among children who were placed on inhaled corticosteroids during this study, however, children treated by physicians who had received education had significantly fewer symptoms and fewer follow-up office visits, nonemergency physician office visits, emergency department visits, and hospitalizations. CONCLUSIONS:The interactive seminar based on theories of self-regulation led to patient-physician encounters that were of shorter duration, had significant impact on the prescribing and communications behavior of physicians, led to more favorable patient responses to physicians' actions, and led to reductions in health care utilization.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Clark NM,Gong M,Schork MA,Evans D,Roloff D,Hurwitz M,Maiman L,Mellins RB

doi

10.1542/peds.101.5.831

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

831-6

issue

5

eissn

0031-4005

issn

1098-4275

journal_volume

101

pub_type

临床试验,杂志文章,随机对照试验
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    abstract:OBJECTIVE:This study evaluates the impact that a Medicaid managed care program had on avoidable hospitalization, a form of health care misuse that we hypothesize can be reduced by improved access to and quality of primary care in the context of a managed care program. Ambulatory care sensitive (ACS) hospitalizations, a...

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    doi:10.1542/peds.101.3.e1

    authors: Gadomski A,Jenkins P,Nichols M

    更新日期:1998-03-01 00:00:00

  • Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention.

    abstract:OBJECTIVE:The goal was to determine the impact of a community-wide educational intervention on parental misconceptions likely contributing to pediatric antibiotic overprescribing. METHODS:We conducted a cluster-randomized trial of a 3-year, community-wide, educational intervention directed at parents of children < 6 y...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2006-2600

    authors: Huang SS,Rifas-Shiman SL,Kleinman K,Kotch J,Schiff N,Stille CJ,Steingard R,Finkelstein JA

    更新日期:2007-04-01 00:00:00

  • Total population estimate of newborn special-care bed needs.

    abstract::In 1977, 7% of the 38,855 infants born in Utah were estimated to have required a total of 27,439 special-care hospital days. About half (53%) were mildly ill; their average length of stay was 4.6 days, or 24% of the total hospital-days. Another 20% of the infants had intermediate illness, with a 12-day average stay, o...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Jung AL,Streeter NS

    更新日期:1985-06-01 00:00:00

  • A Quality Improvement Initiative: Improving the Frequency of Inpatient Electronic Prescribing.

    abstract:OBJECTIVE:To improve the frequency of electronic prescribing (e-prescribing) of discharge prescriptions at a children's hospital via a bundle of quality improvement interventions. METHODS:Surveys and focus groups were conducted with patient families and pediatric residents to identify barriers and propose solutions to...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-0760

    authors: Fuchs J,Lo HY,Peterman A,Camp E,Chase L

    更新日期:2016-11-01 00:00:00

  • Trampoline Park and Home Trampoline Injuries.

    abstract:BACKGROUND AND OBJECTIVE:Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs). ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-1236

    authors: Kasmire KE,Rogers SC,Sturm JJ

    更新日期:2016-09-01 00:00:00

  • The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support.

    abstract::This publication contains the pediatric and neonatal sections of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (COSTR). The consensus process that produced this document was sponsored by the International Liaison Committee on ...

    journal_title:Pediatrics

    pub_type: 杂志文章,实务指引

    doi:10.1542/peds.2006-0206

    authors: International Liaison Committee on Resuscitation.

    更新日期:2006-05-01 00:00:00

  • Race, otitis media, and antibiotic selection.

    abstract:BACKGROUND AND OBJECTIVE:Previous research suggests that physicians may be less likely to diagnose otitis media (OM) and to prescribe broad-spectrum antibiotics for black versus nonblack children. Our objective was to determine whether race is associated with differences in OM diagnosis and antibiotic prescribing natio...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-1781

    authors: Fleming-Dutra KE,Shapiro DJ,Hicks LA,Gerber JS,Hersh AL

    更新日期:2014-12-01 00:00:00

  • Health consequences of behaviors: injury as a model.

    abstract::Injury is the third leading cause of death in the United States and the leading cause for children, adolescents, and young adults. Injury results from multiple factors and so may its prevention. The first and simplest approach toward preventing injuries has been to innovatively and aggressively apply a traditional pub...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Irwin CE Jr,Cataldo MF,Matheny AP Jr,Peterson L

    更新日期:1992-11-01 00:00:00

  • Pharmacologic compliance with antibiotic therapy for acute otitis media: influence on subsequent middle ear effusion.

    abstract::The frequency of otitis media with effusion (serous otitis media, secretory otitis media) detected after conventional antibiotic treatment of acute otitis media is approximately 50%. The relationship between pharmacologic compliance and the frequency of otitis media with effusion was studied. A Micrococcus lutea bioin...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Schwartz RH,Rodriquez WJ,Grundfast KM

    更新日期:1981-11-01 00:00:00

  • Linkages between internet and other media violence with seriously violent behavior by youth.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-3377

    authors: Ybarra ML,Diener-West M,Markow D,Leaf PJ,Hamburger M,Boxer P

    更新日期:2008-11-01 00:00:00

  • A pacifier increases the risk of recurrent acute otitis media in children in day care centers.

    abstract:OBJECTIVE:To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). METHOD:In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-mont...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Niemelä M,Uhari M,Möttönen M

    更新日期:1995-11-01 00:00:00

  • Determinants of health care use by children in rural western North Carolina: results from the Mountain Accessibility Project.

    abstract:OBJECTIVE:To assess determinants of health care visits among children in a 12-county region of western North Carolina representative of rural areas in the United States. METHODS:Households were randomly selected for surveys of household characteristics, health status, and health care use. Surveys were conducted June 1...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.112.2.e143

    authors: Woods CR,Arcury TA,Powers JM,Preisser JS,Gesler WM

    更新日期:2003-08-01 00:00:00

  • Eleven plasma proteins as indicators of protein nutritional status in very low birth weight infants.

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    pub_type: 杂志文章

    doi:

    authors: Polberger SK,Fex GA,Axelsson IE,Räihä NC

    更新日期:1990-12-01 00:00:00

  • The Diagnosis of Polycystic Ovary Syndrome in Adolescents.

    abstract::Consensus has recently been reached by international pediatric subspecialty societies that otherwise unexplained persistent hyperandrogenic anovulation using age- and stage-appropriate standards are appropriate diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescents. The purpose of this review is to su...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

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    authors: Rosenfield RL

    更新日期:2015-12-01 00:00:00

  • Clinical profile of 30 infants with acute pulmonary hemorrhage in Cleveland.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.110.3.627

    authors: Dearborn DG,Smith PG,Dahms BB,Allan TM,Sorenson WG,Montana E,Etzel RA

    更新日期:2002-09-01 00:00:00

  • Creation and development of the public service orphan drug Human Botulism Immune Globulin.

    abstract::The public service orphan drug Human Botulism Immune Globulin for the treatment of infant botulism would not have come into existence without the federal Orphan Drug Act and the funding mechanism that it provided to conduct pivotal clinical trials. Nonetheless, creating, developing, and achieving licensure of Human Bo...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2006-0646

    authors: Arnon SS

    更新日期:2007-04-01 00:00:00

  • A systematic review of vocational interventions for young adults with autism spectrum disorders.

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    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2012-0682

    authors: Taylor JL,McPheeters ML,Sathe NA,Dove D,Veenstra-Vanderweele J,Warren Z

    更新日期:2012-09-01 00:00:00

  • Conceptions of illness in young adolescents.

    abstract::This study examined conceptions of illness in young adolescents. A group of 77 urban junior high school students aged 11 to 15 years were asked for their definitions of illness. Themes occurring in definitions of illness were identified and coded according to a previously developed coding scheme. Evidence in support o...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Millstein SG,Adler NE,Irwin CE Jr

    更新日期:1981-12-01 00:00:00

  • Outcome measures of interventions in the study of children of substance-abusing parents.

    abstract::Children of substance-abusing parents, including children of alcoholics (COAs), are one of the highest risk groups of youth for substance-abuse problems. For both genetic and family environmental reasons, COAs and children of drug abusers are very vulnerable to becoming alcohol or other drug abusers.1,2 With drug use ...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Kumpfer KL

    更新日期:1999-05-01 00:00:00

  • Quality of primary care and subsequent pediatric emergency department utilization.

    abstract:OBJECTIVE:Our objective was to determine whether parent-reported, high-quality primary care was associated with decreased nonurgent pediatric emergency department utilization. METHODS:A retrospective analysis of prospectively collected data for a cohort of children from the 2000-2001 and 2001-2002 Medical Expenditure ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-3518

    authors: Brousseau DC,Hoffmann RG,Nattinger AB,Flores G,Zhang Y,Gorelick M

    更新日期:2007-06-01 00:00:00

  • RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth.

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    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2011-3447

    authors: Taussig HN,Culhane SE,Garrido E,Knudtson MD

    更新日期:2012-07-01 00:00:00

  • Can developmental screening tests identify children who are developmentally at risk?

    abstract::Developmental screening tests are in widespread use, but few reliable and valid tests are available. The most frequently used screening instrument for detecting young children who are at risk for developmental delays is the Denver Developmental Screening Test (DDST). Although the DDST has excellent test specificity, o...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Meisels SJ

    更新日期:1989-04-01 00:00:00

  • Continuous Noninvasive Carbon Dioxide Monitoring in Neonates: From Theory to Standard of Care.

    abstract::Ventilatory support may affect the short- and long-term neurologic and respiratory morbidities of preterm infants. Ongoing monitoring of oxygenation and ventilation and control of adequate levels of oxygen, pressures, and volumes can decrease the incidence of such adverse outcomes. Use of pulse oximetry became a stand...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2018-3640

    authors: Hochwald O,Borenstein-Levin L,Dinur G,Jubran H,Ben-David S,Kugelman A

    更新日期:2019-07-01 00:00:00

  • A systematic review of treatments for infant colic.

    abstract:OBJECTIVE:To conduct a systematic review of rigorously evaluated treatments for infant colic. METHODS:Online bibliographic databases were searched for the term "colic" in articles classified as clinical trials or randomized controlled trials and conducted in infants. Reference lists from review articles, meta-analyses...

    journal_title:Pediatrics

    pub_type: 杂志文章,meta分析

    doi:

    authors: Garrison MM,Christakis DA

    更新日期:2000-07-01 00:00:00

  • Beyond the "big talk": the roles of breadth and repetition in parent-adolescent communication about sexual topics.

    abstract:OBJECTIVE:Most studies of parent-adolescent communication about sexuality focus on the frequency of communication without distinguishing between the breadth of topics covered and repetition. The goal of this study was to assess the independent influence of breadth and repetition of sexual discussion on adolescents' per...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2007-2156

    authors: Martino SC,Elliott MN,Corona R,Kanouse DE,Schuster MA

    更新日期:2008-03-01 00:00:00

  • Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection.

    abstract:OBJECTIVES:To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. METHODS:We used growth curve modeling to analyze t...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-1517

    authors: Lopez AS,Lanzieri TM,Claussen AH,Vinson SS,Turcich MR,Iovino IR,Voigt RG,Caviness AC,Miller JA,Williamson WD,Hales CM,Bialek SR,Demmler-Harrison G,Congenital Cytomegalovirus Longitudinal Study Group.

    更新日期:2017-11-01 00:00:00

  • Recurring digital fibrous tumors of childhood: a review.

    abstract::Two new cases that conform to the clinical and histopathological features of recurring digital fibrous tumor of childhood, described by Reye in 1965, are reported. This tumor, which is considered a distinct entity among the juvenile fibromatoses, characteristically presents in infancy and early childhood, involves onl...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Beckett JH,Jacobs AH

    更新日期:1977-03-01 00:00:00

  • Responding to parental refusals of immunization of children.

    abstract::The American Academy of Pediatrics strongly endorses universal immunization. However, for childhood immunization programs to be successful, parents must comply with immunization recommendations. The problem of parental refusal of immunization for children is an important one for pediatricians. The goal of this report ...

    journal_title:Pediatrics

    pub_type: 指南,杂志文章

    doi:10.1542/peds.2005-0316

    authors: Diekema DS,American Academy of Pediatrics Committee on Bioethics.

    更新日期:2005-05-01 00:00:00

  • Superior vena cava syndrome in childhood: report of ten cases and review of the literature.

    abstract::Experience with ten children with superior vena cava obstruction is reported. Five patients had non-Hodgkin's lymphoma, two had Hodgkin's disease, two had benign lesions, and one patient was suspected on clinical and radiologic basis to have a lymphoma. The clinical situation at presentation was often critical and req...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Issa PY,Brihi ER,Janin Y,Slim MS

    更新日期:1983-03-01 00:00:00

  • Placental features in preterm infants with periventricular leukomalacia.

    abstract:OBJECTIVE:Evaluation of the placenta provides some important insights into pathophysiologic changes that take place during the prenatal and intrapartum process. We investigated the relationship between placental findings and periventricular leukomalacia (PVL) to obtain a better understanding of its cause. METHODS:Thir...

    journal_title:Pediatrics

    pub_type: 杂志文章

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    更新日期:2002-04-01 00:00:00