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Unanswered questions prompted during pediatric primary care visits

Chuck Norlin1, Adam L Sharp, Sean D Firth

  • 1Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA. chuck.norlin@hsc.utah.edu

Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association
|September 18, 2007
PubMed

Insights

Pediatricians face unanswered questions in nearly 20% of visits, especially with children with special health care needs (CSHCN). Answers are pursued for few of these important questions, highlighting a need for better support.

Area of Science:

  • Pediatric Primary Care
  • Clinical Question Answering
  • Health Services Research

Background:

  • Pediatric primary care visits frequently generate questions that clinicians cannot immediately answer.
  • Understanding the scope and management of these unanswered questions is crucial for improving patient care.

Purpose of the Study:

  • To determine the frequency, types, and importance of unanswered questions in pediatric primary care.
  • To characterize pediatrician responses to these questions.
  • To compare questions arising from visits with children with special health care needs (CSHCN) versus those without (Cw/oSN).

Main Methods:

  • Observation of 890 patient visits with 35 general pediatricians.
  • Use of a CSHCN screener for parents.
  • Physician self-reporting on unanswered questions and answer pursuit.

Main Results:

  • 19.1% of visits prompted unanswered questions, 60.1% deemed important.
  • Answers were pursued for only 27.5% of questions due to time and resource barriers.
  • Unanswered questions were more frequent in visits with CSHCN (28.7%) than Cw/oSN (16.9%), particularly during well visits.

Conclusions:

  • Nearly 20% of pediatric primary care visits result in unanswered questions.
  • Visits involving CSHCN generate more unanswered questions, often related to diagnosis and treatment.
  • Few unanswered questions are pursued, indicating a need for strategies like increased visit time for CSHCN.
Abstract

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