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在内部医学实习期间病例暴露的变化
Andrew C L Lam1, Brandon Tang2, Chang Liu3
1Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
内科住院医生在患者病例暴露方面经历了显著的变化,影响了学习和准备. 一个综合数据库揭示了居民,医院和随着时间的推移之间的差异,突出了公平培训的需要.
科学领域:
- 医学教育 医学教育
- 医疗信息学 医疗信息学
- 内部医学培训培训 内部医学培训
背景情况:
- 居民病例暴露的变化影响学习和未来的实践准备.
- 由于缺乏可靠的患者和住院人员联系方法,因此无法准确报告病例暴露情况.
研究的目的:
- 开发一个综合的教育和临床数据库,用于表征和测量内科医生之间的病例暴露变异性.
主要方法:
- 一项队列研究将一夜间内科呼叫班期间入院的患者与加拿大5家教学医院的高级住院人员联系起来.
- 分析了与793名居民 (2010-2019) 相关的143,632次入院的数据.
- 病例暴露被定义为患者的人口统计学,诊断,敏度,复杂性 (查尔森并发症指数) 和健康的社会决定因素.
主要成果:
- 在住院,医院和时间层面观察到病例暴露的实质性变化.
- 居住在最高四分位数的居民与最低四分位数相比,需要重症监护转移的入院人数几乎是最低四分位数的4倍.
- 随着时间的推移,尽管工作时间相似,住院居民每班的入院和患者复杂性的增加.
结论:
- 在内部医学住院人员之间,在不同医院站点和随着时间的推移,病例暴露存在显著差异.
- 开发的综合数据库有效地描述了这些变异.
- 解决这种变化对于确保公平的居民教育和准备工作至关重要.
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