Biomaterial Database

Comparison of critical care provided by family physicians and general internists. 1988

B L Hainer, and F H Lawler

Department of Family Medicine, East Carolina University School of Medicine, Greenville, NC 27858-1988.

Privilege conflicts and credentialing issues involving family physicians' care of hospitalized patients are controversial areas. This study compares the process and outcome of critical care provided by family physicians and general internists. We studied 523 patients admitted by these specialists to the medical intensive and cardiac care units of a large regional hospital over a one-year period. The length of stay and readmission rate in the intensive care unit and hospital, severity of illness, discharge diagnosis, proportion who died, time until death of those who died, consultation rate, and hospital charges did not differ significantly between patients cared for by physicians in the two specialties. Application of Cox's proportional hazard model to the data indicated the risk of death to be significantly related to patient race, age, and severity of illness, but not to physician specialty. Regression analysis of several morbidity variables showed no relationship to physician specialty. Lack of differences in outcome and process in the hospital studied leads us to believe that both family physicians and general internists are entitled to have equal access to the care of patients in critical care units.

UI	MeSH Term	Description	Entries
D007388	Internal Medicine	A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.	General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009026	Mortality	All deaths reported in a given population.	CFR Case Fatality Rate,Crude Death Rate,Crude Mortality Rate,Death Rate,Age Specific Death Rate,Age-Specific Death Rate,Case Fatality Rate,Decline, Mortality,Determinants, Mortality,Differential Mortality,Excess Mortality,Mortality Decline,Mortality Determinants,Mortality Rate,Mortality, Differential,Mortality, Excess,Age-Specific Death Rates,Case Fatality Rates,Crude Death Rates,Crude Mortality Rates,Death Rate, Age-Specific,Death Rate, Crude,Death Rates,Determinant, Mortality,Differential Mortalities,Excess Mortalities,Mortalities,Mortality Declines,Mortality Determinant,Mortality Rate, Crude,Mortality Rates,Rate, Age-Specific Death,Rate, Case Fatality,Rate, Crude Death,Rate, Crude Mortality,Rate, Death,Rate, Mortality,Rates, Case Fatality
D010043	Outcome and Process Assessment, Health Care	Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.	Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D012017	Referral and Consultation	The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.	Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D003422	Critical Care	Health care provided to a critically ill patient during a medical emergency or crisis.	Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005194	Family Practice	A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.	Family Practices,Practice, Family,Practices, Family
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man