Roos N P, Fransoo R, Bogdanovic B, Carriere K C, Frohlich N, Friesen D, Patton D, Wall R
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Med Care. 1999 Jun;37(6 Suppl):JS206-28. doi: 10.1097/00005650-199906001-00017.
The Manitoba Centre for Health Policy and Evaluation (MCHPE) collaborated with a provincially-appointed Physician Resource Committee in an assessment of provincial physician resources.
Beginning with map-based analyses of physician supply and contacts across the province, compared with the health and socioeconomic characteristics of local populations, the study moved to a needs-based, regression-based approach to physician resource planning.
The results challenged the popular belief that Manitoba suffers from an increasing shortage of physicians. A handful of high-need, low-supply and low-use areas are identified, as is the expensive surplus of generalist physicians in Winnipeg. (Generalist physicians include general and family practitioners as well as general internists and pediatricians.) No relationship between physician supply and health characteristics of populations, or between high physician supply and low hospital use patterns were found. Given the Committee's interest in what drives high physician contact rates, analyses of visit patterns of hypertensive patients were undertaken. We found that patients who had more complex medical conditions made more contacts, but that after controlling for this and other key patient characteristics, the patient's primary care physician's patient recall rate was a strong influence on how frequently visits were made.
曼尼托巴省卫生政策与评估中心（MCHPE）与一个省级任命的医师资源委员会合作，对该省的医师资源进行评估。
该研究首先对全省的医师供应情况和分布进行基于地图的分析，并与当地人口的健康和社会经济特征进行比较，然后转向基于需求的、基于回归的医师资源规划方法。
研究结果对一种普遍看法提出了挑战，即曼尼托巴省医师短缺情况日益严重。研究确定了少数需求高、供应少且利用率低的地区，以及温尼伯市全科医师供应过剩的情况（全科医师包括普通和家庭医生以及普通内科医生和儿科医生）。研究未发现医师供应与人群健康特征之间存在关联，也未发现医师供应高与医院低使用模式之间存在关联。鉴于委员会对导致高医师接触率的因素感兴趣，因此对高血压患者的就诊模式进行了分析。我们发现，患有更复杂疾病的患者就诊次数更多，但在控制了这一因素和其他关键患者特征后，患者的初级保健医生的患者召回率对就诊频率有很大影响。
