Pathman Donald E, Konrad Thomas R, Dann Rebekkah, Koch Gary
Cecil G. Sheps Center for Health Services Research, University of North Carolina CB#7590, Chapel Hill, NC 27599, USA.
Am J Public Health. 2004 Oct;94(10):1723-9. doi: 10.2105/ajph.94.10.1723.
We tested the assumption that average job retention duration is shorter for physicians in rural health professional shortage areas (HPSAs) than for physicians in rural non-HPSAs.
In 1991, we surveyed nationally representative samples of primary care physicians who recently had moved to rural HPSAs and non-HPSAs who were without service obligations. We resurveyed these physicians in 1996 and 1997 to learn of any job changes.
Physicians in rural HPSAs (n=308) demonstrated retention similar to that of the non-HPSA cohort (n=197) (hazard ratio for leaving=1.28; 95% confidence interval=0.97, 1.69; P=.08), even with adjustments for group demographic differences (P=.24).
Average retention duration for generalist physicians in rural HPSAs is identical to or slightly shorter than for those in rural non-HPSAs. Poor recruitment is likely to be the principal dynamic underlying local rural shortages.
我们检验了这样一种假设,即农村卫生专业人员短缺地区(HPSA)的医生平均工作保留时长比农村非HPSA地区的医生短。
1991年,我们对最近搬到农村HPSA地区且无服务义务的基层医疗医生以及农村非HPSA地区的医生进行了全国代表性抽样调查。1996年和1997年,我们对这些医生进行了再次调查,以了解他们的工作变动情况。
农村HPSA地区的医生(n = 308)与非HPSA队列(n = 197)的留任情况相似(离职风险比 = 1.28;95%置信区间 = 0.97,1.69;P = 0.08),即使对两组人口统计学差异进行调整后也是如此(P = 0.24)。
农村HPSA地区全科医生的平均留任时长与农村非HPSA地区的医生相同或略短。招聘困难可能是导致当地农村医疗人员短缺的主要原因。