Firearm injury prevention counseling by pediatricians and family physicians: practice and beliefs

Article Abstract:

Few pediatricians or family physicians appear to counsel parents about gun safety, although most agree the issue is important. A group of 979 pediatricians and family physicians responded to a survey of beliefs and practices regarding gun safety and children. Seventy percent of pediatricians and 47% of family physicians agreed that doctors have a responsibility to counsel patients. Despite this, 48% of pediatricians and 56% of family physicians never counseled parents and only 20% and 8%, respectively, counseled more than 5% of their patients. Perceived barriers to counseling included not knowing what to advise or believing gun-owning parents would not be receptive to removing guns from the house. Doctors who believed that parents should not keep guns in the home were 15 times more likely not to own guns themselves and twice as likely to be pediatricians as family physicians. The majority of doctors agreed that parents would accept advice to lock up guns or bullets.

Prevention, Gunshot wounds, Children's accidents

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Practice variations among pediatricians and family physicians in the management of otitis media

Article Abstract:

Family physicians and pediatricians appear to have different treatment patterns for persistent otitis media. Otitis media is an infection or inflammation of the middle ear that is common in children. Researchers surveyed 142 family physicians and 114 pediatricians to study how the doctors diagnose and treat persistent and recurrent otitis media in children. Family physicians were twice as likely as pediatricians to prescribe high-cost antibiotics for persistent otitis media. The duration of antibiotic treatment ranged from 10 days to at least 30 days. Family physicians were more than three times as likely as pediatricians to recommend decongestants for persistent otitis media. Family physicians were almost three times as likely as pediatricians to refer patients for ventilating tube surgery after nine weeks of persistent otitis media. Both physician groups treat recurrences of otitis media similarly.

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Utilization of services for otitis media by children enrolled in Medicaid

Article Abstract:

Utilization of care rates for treating middle ear infections in children may be calculated. This data can be helpful to health maintenance organizations and insurers. Researchers analyzed data from 131,000 Medicaid-enrolled Colorado children in 1991 and 157,000 children in 1992. There were 0.5 clinic visits per year per child under age 13 or 0.7 visits per child-year. Overall, 0.34 courses of antibiotics were prescribed per child, 0.48 per child-year, and 1.55 per child with otitis media. There were 12 surgical procedures per 1,000 children or 16.6 per 1,000 child-years.

Services, Medicaid

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