Frank Erica, Modi Surbhi, Elon Lisa, Coughlin Steven S
University of British Columbia, Department of Health Care and Epidemiology, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3.
Prev Med. 2008 Jul;47(1):140-5. doi: 10.1016/j.ypmed.2007.12.015. Epub 2008 Jan 3.
Accessing adequate medical services remains a major struggle for many Americans, but U.S. medical students' beliefs regarding access to care have not been thoroughly examined.
All medical students in the Class of 2003 at 16 U.S. schools were eligible to complete three questionnaires during their medical training: during freshman orientation, orientation to wards, and their senior year (n=2316, response rate=80.3%). Students responded to three questions about health care provision.
Overall, 35% of students strongly agreed that "physicians have a responsibility to take care of patients regardless of their ability to pay;" only 5% disagreed. Only 8% disagreed that "access to basic health care is a fundamental human right." We found the same significant associations with opinions on access as we did with "responsibility to treat," although the associations tended to be stronger for access. Only 10% of students agreed that "Managed care, as it is now delivered, is a good way to deliver health care to the U.S. population."
Most U.S. medical students support universal access to medical care, though variations in this support, its decline with additional years of medical education, and concerns about managed care are noteworthy, and have policy implications for America's health and health care workforce.
获得足够的医疗服务对许多美国人来说仍然是一项艰巨的任务，但美国医学生对获得医疗服务的看法尚未得到充分研究。
美国16所学校2003级的所有医学生在医学培训期间有资格完成三份问卷：在新生入学指导、病房实习指导和大四时（n = 2316，回复率 = 80.3%）。学生们回答了三个关于医疗保健提供的问题。
总体而言，35%的学生强烈同意“医生有责任照顾患者，无论其支付能力如何”；只有5%的学生不同意。只有8%的学生不同意“获得基本医疗保健是一项基本人权”。我们发现，在获得医疗服务的看法方面，与“治疗责任”方面存在相同的显著关联，尽管这些关联在获得医疗服务方面往往更强。只有10%的学生同意“目前实施的管理式医疗是为美国民众提供医疗服务的好方式”。
大多数美国医学生支持普遍获得医疗服务，不过这种支持存在差异、随着医学教育年限增加而下降以及对管理式医疗的担忧值得关注，并且对美国的健康和医疗劳动力具有政策意义。
