Helton Margaret R, Pathman Donald E
Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599-7595, USA.
Fam Med. 2008 Nov-Dec;40(10):707-14.
As the US population ages, more physicians will be needed to provide care for older patients. We characterized family medicine residents' plans to include care of the elderly and to patients in nursing homes in their future practices. We also assessed whether residents' plans were related to their attitudes toward the elderly and the professional and financial satisfaction they foresaw in providing care to the elderly. We further examined the obstacles and incentives they perceived for providing nursing home care.
A written survey of residents in the seven residency programs of the Department of Family Medicine of the University of North Carolina.
In total, 116 of the 139 residents responded (83.5%). Residents generally reported positive attitudes toward elderly patients. Nearly all residents (92.1%) planned to care for geriatric patients in their office, but only two thirds (68.1%) anticipated that older people will comprise a significant percentage of their practice. Interns were more interested in care for the elderly than were second- and third-year residents. Most residents did not anticipate that they will be professionally or financially satisfied with or enjoy nursing home care, and only 26.1% planned to provide care in nursing homes. Time constraints and financial concerns were often cited as obstacles to nursing home care.
Family medicine residents have limited interest in nursing home care and may generally underestimate the influence of an aging society on their future practice. Meeting the health care needs of an aging society will require innovations in reimbursement, health care delivery systems, and residency curricula.
随着美国人口老龄化，将需要更多医生为老年患者提供护理。我们描述了家庭医学住院医师在未来执业中纳入老年护理及疗养院患者护理的计划。我们还评估了住院医师的计划是否与他们对老年人的态度以及他们预计在为老年人提供护理时的职业和经济满意度相关。我们进一步研究了他们认为提供疗养院护理的障碍和激励因素。
对北卡罗来纳大学家庭医学系七个住院医师培训项目的住院医师进行书面调查。
139名住院医师中共有116名做出回应（83.5%）。住院医师总体上对老年患者持积极态度。几乎所有住院医师（92.1%）计划在其诊所护理老年患者，但只有三分之二（68.1%）预计老年人将占其执业患者的很大比例。实习生比二年级和三年级住院医师对老年护理更感兴趣。大多数住院医师预计他们在疗养院护理方面不会获得职业或经济上的满足感或享受其中，只有26.1%的人计划在疗养院提供护理。时间限制和经济担忧经常被认为是疗养院护理的障碍。
家庭医学住院医师对疗养院护理兴趣有限，可能普遍低估了老龄化社会对其未来执业的影响。满足老龄化社会的医疗保健需求将需要在报销、医疗保健提供系统和住院医师培训课程方面进行创新。
