RESUMO
OBJECTIVE: To assess the current distribution and training patterns of pediatric nurse practitioners (PNPs). STUDY DESIGN: Secondary data analysis from the National Association of Pediatric Nurse Practitioners and the 2008 US Census Bureau were used to estimate the distribution of PNPs per 100,000 children. Data on nurse practitioner (NP) graduation and specialty education programs were obtained from the American Association of Colleges of Nursing. RESULTS: PNPs have the greatest concentration in the New England and mid-Atlantic regions and a narrow band of Midwestern states. States that allow PNPs to practice or prescribe independently do not consistently have a higher density of PNPs per child population. There has been a slight decrease in the proportion of programs that offer PNP training. In the last decade, the proportion of NP graduates pursuing family nurse practitioner education has increased, and the proportion pursuing PNP education has decreased. CONCLUSION: Workforce planning for the health care of children will require improved methods of assessment of the role of PNPs and the volume of care they provide. Increased use of PNPs in pediatrics will likely require greater effort at recruitment of NPs into the PNP specialty.
Assuntos
Educação/estatística & dados numéricos , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/estatística & dados numéricos , Enfermagem Pediátrica , Área Programática de Saúde , Certificação , Criança , Emprego/estatística & dados numéricos , Emprego/tendências , Humanos , Pesquisa em Avaliação de Enfermagem/normas , Pesquisa em Avaliação de Enfermagem/estatística & dados numéricos , Serviços de Enfermagem/normas , Serviços de Enfermagem/estatística & dados numéricos , Enfermagem Pediátrica/educação , Enfermagem Pediátrica/estatística & dados numéricos , Enfermagem Pediátrica/tendências , Seleção de Pessoal/estatística & dados numéricos , Assistentes Médicos/educação , Assistentes Médicos/normas , Padrões de Prática Médica/organização & administração , Especialidades de Enfermagem/normas , Especialidades de Enfermagem/estatística & dados numéricos , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To determine the current proportion of pediatric primary care and specialty visits being conducted by pediatricians versus other providers. STUDY DESIGN: We used data from 1980-2006 National Ambulatory Medical Care Surveys (NAMCS) to examine trends in office visits by patients 0 to 17 years of age. During our years of interest, the total number of visits in NAMCS by children ranged from 2597 to 9220 per year. RESULTS: Overall, the percentage of all nonsurgical physician office visits for children 0 to 17 years of age made to general pediatricians increased from 61% in 1996 to 71% in 2006 and those to nonpediatric generalists fell from 28% to 22%. The greatest changes between 2000 and 2006 occurred in the adolescent age group where the proportion of visits to general pediatricians increased from 38% to 53%. CONCLUSIONS: Pediatricians continue to provide most primary care visits for children in the United States. For the first time, pediatricians now provide most visits for adolescents.
Assuntos
Serviços de Saúde da Criança/tendências , Visita a Consultório Médico/estatística & dados numéricos , Pediatria/tendências , Médicos/tendências , Atenção Primária à Saúde/tendências , Adolescente , Fatores Etários , Criança , Serviços de Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Médicos/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo , Estados UnidosRESUMO
OBJECTIVES: To characterize parental attitudes regarding board certification and other factors that influence selection of physicians to care for children. STUDY DESIGN: A web-based survey administered in 2008 to a random sample of 3621 adults >or=18 years of age stratified by parents and non-parents. Proportion of respondents who view board certification and other measures of quality as important factors in selecting a physician to care for children. RESULTS: Survey completion rate was 62%. Almost all (95%) believe it is important or very important for doctors who care for children to be assessed on their quality of care, receive high ratings from patients (91%), and pass a written test at regular intervals (88%). Most reported that recommendations from friends or family (84%) and board certification (82%) were important or very important factors in choosing a physician for their child. Seventy-seven percent of parents stated that they would be likely to change their child's physician if he/she did not maintain board certification. CONCLUSION: Parents report a preference for board-certified physicians and expect them to participate in Maintenance of Certification. Greater understanding of quality measures and the board certification process would empower consumers to make more informed decisions in selecting a physician for their children.
Assuntos
Atitude , Certificação , Pais/psicologia , Pediatria/normas , Médicos de Família/normas , Adulto , Criança , Comportamento de Escolha , Comportamento do Consumidor , Coleta de Dados , Avaliação Educacional , Humanos , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Estados Unidos , Adulto JovemRESUMO
OBJECTIVE: Since diplomates of the American Board of Pediatrics with permanent certificates will not be required to participate in the Maintenance of Certification (MOC) program, we determined the perceptions of permanent certificate holders about MOC and their degree of interest in participation. STUDY DESIGN: We conducted a 12-item mail survey of 1693 diplomates with permanent certificates. Frequency distributions were calculated for all survey items. chi(2) statistics were used to explore associations between the variables. RESULTS: The response rate was 77.7%. Less than one-third of generalist respondents (28%, n = 122) and 13% of subspecialists (n = 63) agreed that they would be willing to participate in general pediatrics MOC (P < .0001). However, approximately half the subspecialists (48%, n = 221) agreed that they would be willing to participate in subspecialty MOC. Approximately three-fourths of generalists (79%, n = 354) and subspecialists (74%, n = 338) disagreed that MOC is necessary for keeping up-to-date in clinical pediatrics. Few respondents believed that parents understand the MOC program. CONCLUSION: A wide range of attitudes and perceptions about MOC exists among holders of permanent certificates. Concerns about the importance of MOC to parents and the usefulness of MOC participation in improving quality of care will need to be addressed.