A survey of community (out-of-hospital) sites used in pediatric training.

A survey was completed of US pediatric residency programs about the use of community sites in training. A total of 85% of program directors responded and reported a wide use of the 21 identified survey sites. Further study is needed to determine the appropriate contribution that community sites can make to pediatric training.

Prospective evaluation of routine admission urinalyses.

Nine hundred fifty-four pediatric patients admitted to our hospital had a "dipstick" urinalysis. Glucosuria, hematuria, and proteinuria were found in 6.0%, 5.3%, and 2.5%, respectively. By requiring two urinalyses and by eliminating artifacts that led to false-positive results, these rates declined to 0.9%, 2.2%, and 0.6%. A verbal "prompt" of the house staff was used to achieve a 95% follow-up rate. Four new diagnoses resulted from the effort: juvenile-onset diabetes mellitus, pelvic kidney, sickle cell trait, and asymptomatic bacteriuria. However, it is questionable as to whether any of these patients benefited. In addition, when specific screening criteria are applied, it is difficult to justify a routine screening urinalysis on every pediatric hospital admission. The cost of screening, diagnosis, and treatment was $3,671. Recommendations are given to those undertaking any hospital admission screening effort.