Case mix in a primary care teaching practice for two clerkship schedules.
Student-physicians saw patients from assigned families at primary care training sites either one or two half-days a week. These practice conditions caused a skewing of diagnoses away from seeing acute conditions. Students who saw patients two half-days a week made 21 percent fewer acute care diagnoses than were made in the practice. Those students at the clinical site one half-day a week saw 28 percent fewer acute disease diagnoses. Accordingly, there was an increase in the percentage of chronic disease and health supervision diagnoses in the case mix of these student-physicians. This part-time scheduling of students at the training sites was related to a disruption in continuity of care for the patient. While a little less than half of acute illness care was performed by student-physicians, over two thirds of chronic disease diagnoses were made by these once-or-twice-a-week trainees. Almost nine tenths of health care supervision was accomplished within the trainees' twice-a-week schedule.
D000208:Acute Disease; D002908:Chronic Disease; D003151:Community Health Centers; D003266:Continuity of Patient Care; D004504:Education, Medical, Undergraduate; D005194:Family Practice / Q000193:education*; D006801:Humans; D007087:Illinois; D010561:Personnel Staffing and Scheduling; D011231:Preceptorship; D013997:Time Factors