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Perspective of a pediatric nephrology program: an 18 year retrospective
J I Scheinman1, J W Foreman, J C Chan
1Department of Pediatrics, Virginia Commonwealth University's Medical College of Virginia, Richmond, VA, USA.
Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|December 24, 1997
Summary
Pediatric nephrology training is distinct from internal medicine programs. Managed care did not impact patient referrals for kidney disorders in children.
Area of Science:
- Pediatric Nephrology
- Medical Education
- Health Services Research
Background:
- Pediatric nephrology training programs require specialized curricula.
- The landscape of healthcare delivery has evolved with managed care.
- Understanding patient referral patterns is crucial for healthcare planning.
Purpose of the Study:
- To evaluate the suitability of internal medicine nephrology programs for pediatric training.
- To compare pediatric patient referral rates before and after the implementation of managed care.
- To review guidelines for renal biopsy and treatment in pediatric nephrology.
Main Methods:
- Analysis of patient data from a pediatric nephrology training program over 18 years (1977-1996).
- Comparison of referral rates in a metropolitan area with and without "gatekeeper" insurance systems.
- Utilized NIH clinical data forms for consistent data collection.
Main Results:
- Data did not support merging pediatric nephrology training into internal medicine programs due to unique patient needs.
- Managed care competition did not alter patient enrollment or referral rates.
- The majority of new patients (3,150) were under seven years old, with significant numbers requiring biopsy or dialysis/transplant before age 10.
Conclusions:
- Pediatric nephrology training requires dedicated programs separate from internal medicine.
- Healthcare system changes like managed care did not significantly affect patient referral volumes.
- Established guidelines for pediatric renal biopsy and treatment are essential.
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