Division of Otolaryngology-Head & Neck Surgery, The George Washington University, Washington, DC, USA.
Otolaryngol Head Neck Surg. 2011 Jul;145(1):30-4. doi: 10.1177/0194599811406072. Epub 2011 Apr 26.
To investigate the perspectives of resident physicians, in otolaryngology and other specialties, with respect to various health care reform proposals. Also, to determine if these opinions vary between residents training to become general medical doctors versus surgeons and specialists and between those with various levels of educational debt.
Survey of resident physicians across the United States.
Opinions of participants were measured on a 5-point Likert scale.
Of the 1576 respondents, the majority agreed that tort reform and electronic medical records would improve quality of care and help contain health care costs. However, few residents agreed that bundling of services (BOS), hospital-acquired conditions penalties (HACP), and quality-based reimbursement (QBR) would improve the quality of care. Specialists and surgeons, in comparison to generalists, were (1) less likely to agree that BOS, HACP, or QBR would improve the quality of care; (2) more likely to agree that tort reform would help contain health care costs; and (3) more likely to believe that BOS, HACP, or QBR would decrease physician compensation. Higher educational debt burden was also an independent predictor of increased skepticism about health care reforms effects on physician compensation.
Residents in general medicine and surgery/specialty training programs agreed that tort reform and electronic medical records would help improve the quality of health care and help contain costs. However, both groups expressed strong concern that certain elements of the Patient Protection and Affordable Care Act would not achieve these goals.
调查耳鼻喉科和其他专业住院医师对各种医疗改革提案的看法。此外,还确定这些意见是否在接受普通医生培训的住院医师与外科医生和专科医生之间以及在具有不同教育债务水平的住院医师之间存在差异。
对全美住院医师进行的调查。
参与者的意见通过 5 点李克特量表进行衡量。
在 1576 名受访者中,大多数人认为侵权改革和电子病历将提高医疗质量并有助于控制医疗成本。然而,很少有住院医师同意服务捆绑(BOS)、医院获得性疾病处罚(HACP)和基于质量的报销(QBR)将提高医疗质量。与普通医生相比,专家和外科医生更倾向于认为(1)BOS、HACP 或 QBR 不会改善医疗质量;(2)更倾向于认为侵权改革将有助于控制医疗成本;(3)更倾向于认为 BOS、HACP 或 QBR 将降低医生薪酬。较高的教育债务负担也是对医疗改革对医生薪酬影响持怀疑态度的独立预测因素。
普通医学和外科/专科培训项目的住院医师均认为侵权改革和电子病历将有助于提高医疗质量并有助于控制成本。然而,两组都强烈担心《患者保护与平价医疗法案》的某些内容无法实现这些目标。