Scott Clinic, Burlington, NC, USA.
J Rural Health. 2009 Spring;25(2):115-23. doi: 10.1111/j.1748-0361.2009.00207.x.
To assess whether people in the rural Southeast perceive that there is an adequate number of physicians in their communities, assess how these perceptions relate to county physician-to-population (PtP) ratios, and identify other factors associated with the perception that there are enough local physicians.
Adults (n = 4,879) from 150 rural counties in eight southeastern states responded through a telephone survey. Agreement or disagreement with the statement "I feel there are enough doctors in my community" constituted the principal outcome. Weighted chi-square analysis and a generalized estimating equation (GEE) assessed the strength of association between perceptions of an adequate physician workforce and county PtP ratios, individual characteristics, attitudes about and experiences with medical care, and other county characteristics.
Forty-nine percent of respondents agreed there were enough doctors in their communities, 46% did not agree, and 5% were undecided. Respondents of counties with higher PtP ratios were only somewhat more likely to agree that there were enough local doctors (Pearson's correlation coefficient = 0.09, P < .001). Multivariate analyses revealed that perceiving that there were enough local physicians was more common among men, those 65 and older, whites, and those with lower regard for physician care. Perceptions that the local physician supply was inadequate were more common for those who had longer travel distances, problems with affordability, and little confidence in their physicians. Perceptions of physician shortages were more common in counties with higher poverty rates.
County PtP ratios only partially account for rural perceptions that there are or are not enough local physicians. Perceptions of an adequate local physician workforce are also related to how much people value physicians' care and whether they face other barriers to care.
评估农村东南部的人们是否认为他们所在社区有足够数量的医生，评估这些看法与县医生与人口（PtP）比例的关系，并确定与认为当地有足够医生的看法相关的其他因素。
来自八个东南州 150 个农村县的成年人（n = 4879）通过电话调查进行了回答。对“我觉得我所在社区的医生数量足够”这一说法表示同意或不同意构成了主要结果。加权卡方分析和广义估计方程（GEE）评估了对足够医生劳动力的看法与县 PtP 比率、个人特征、对医疗保健的态度和经验以及其他县特征之间的关联强度。
49%的受访者同意他们所在社区有足够的医生，46%的人不同意，5%的人不确定。PtP 比率较高的县的受访者只是稍微更有可能同意当地有足够的医生（Pearson 相关系数 = 0.09，P<.001）。多变量分析显示，认为当地有足够的医生更常见于男性、65 岁及以上的人、白人以及对医生护理评价较低的人。认为当地医生供应不足的情况更常见于旅行距离较长、经济负担能力有问题和对医生信心不足的人。在贫困率较高的县，对医生短缺的看法更为普遍。
县 PtP 比率仅部分解释了农村地区对当地医生数量是否足够的看法。对当地医生劳动力的充足性的看法也与人们对医生护理的重视程度以及他们是否面临其他医疗保健障碍有关。
