RESUMO
BACKGROUND AND OBJECTIVES: This study demonstrates how one family practice residency clinic characterized obstetric clinic patients and assessed obstetric care using birth certificate data (demographic characteristics and risk factors) and birth outcome indicators. METHODS: We compared clinical characteristics and birth outcomes for 901 patients who were delivered by family physicians from the family practice residency clinic with a matched and unmatched group of patients who were delivered by other physicians in the county during 1990-1993. RESULTS: The study clinic patients were at higher risk and had lower use of prenatal care. However, the outcomes of the study clinic patients were significantly better (fewer labor and delivery complications, procedures, Cesarean deliveries, abnormal conditions of newborn, low birth weight deliveries, and preterm birth) or no different from the comparison group of non-clinic patients. CONCLUSIONS: The analysis of birth certificate data provided a favorable assessment of prenatal care provided by a family practice residency clinic. This type of analysis permits comparisons of birth outcomes with other local or regional providers, statewide providers, and the year 2000 national objectives established by the National Center for Health Statistics.
Assuntos
Medicina de Família e Comunidade , Internato e Residência/normas , Padrões de Prática Médica/normas , Cuidado Pré-Natal/normas , Garantia da Qualidade dos Cuidados de Saúde , Adolescente , Adulto , Declaração de Nascimento , Interpretação Estatística de Dados , Medicina de Família e Comunidade/educação , Medicina de Família e Comunidade/normas , Feminino , Humanos , Indiana , Recém-Nascido , Gravidez , Resultado da Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Retrospectivos , Fatores de RiscoRESUMO
Risk assessment is the process by which clinicians screen for conditions that, if unmanaged, result in complications of pregnancy or adverse birth outcomes and for which an intervention would improve the well-being of the mother, child, and family. One of the major US health care goals is that by the year 2000, at least 90% of pregnant women will receive risk appropriate care. This article discusses the major risks to the mother and child during pregnancy, and presents tools to assess pregnancy well-being.
Assuntos
Cuidado Pós-Natal/métodos , Cuidado Pré-Natal/métodos , Diagnóstico Pré-Natal/métodos , Medição de Risco/métodos , Feminino , Humanos , Complicações do Trabalho de Parto/prevenção & controle , Gravidez , Complicações na Gravidez/prevenção & controleRESUMO
Motor vehicle-related accidents and firearm-related violence are the first and second leading causes of adolescent morbidity and mortality. Fortunately, considerable progress has been made in reducing motor vehicle-related injuries and death through state-level legislation designed to decrease alcohol use and increase seat belt use. Homicide and suicide, however, are increasing dramatically among teenagers. Family violence and the epidemic of gang activity also contribute significantly to both; violence portrayed on television, in movies, and in adolescent music also has become a more significant part of teen life. Family physicians are encouraged to implement preventive strategies for combating the problems of injury and violence in their offices, their communities, and on the broader states of medical education and public policy.