Schmitz D F, Baker E, Nukui A, Epperly T
Family Medicine Residency of Idaho, Boise, Idaho, USA.
Rural Remote Health. 2011;11(3):1769. Epub 2011 Jul 25.
Community factors of varied importance help determine the success of achieving and maintaining a physician workforce. The purpose of this study was to develop an evaluation instrument (Community Apgar Questioinnaire) useful to rural Idaho communities' in their assessment of the assets and capabilities related to physician recruitment and retention.
A quantitative scoring interview instrument was developed based on a literature review, site visits and discussions with rural physicians and hospital administrators. A total of 11 rural Idaho communities differing in geography and other known variables were selected, some identified historically to have more success in recruitment and retention (α communities) and some historically noted to have more challenges (β comunities). In each community, the administrator of the hospital and the physician with recruiting responsibilities participated individually in a structured interview.
A total of 11 physicians and 11 CEOs participated in the study. Differences were found across and within classes of factors associated with success in physician recruitment and retention where alpha communities scored higher on Community Apgar Questionnaire metrics. Some differences were noted by respondent class. Cumulative mean Community Apgar scores are higher in communities that have historically better track records in recruitment and retention.
The Community Apgar Questionnaire seems to discriminate between communities with differing assets and capabilities, based on historical community-specific workforce trends. This assessment may allow for identification of both modifiable and non-modifiable factors and also may suggest which factors are most important for a community with limited available resources to address.
各种重要性不同的社区因素有助于决定实现和维持医生队伍的成功与否。本研究的目的是开发一种评估工具（社区阿普加问卷），用于爱达荷州农村社区评估与医生招聘和留用相关的资产和能力。
基于文献综述、实地考察以及与农村医生和医院管理人员的讨论，开发了一种定量评分访谈工具。总共选择了11个爱达荷州农村社区，这些社区在地理位置和其他已知变量方面存在差异，其中一些在历史上被认定在招聘和留用方面更成功（α社区），一些在历史上被指出面临更多挑战（β社区）。在每个社区，医院管理人员和负责招聘的医生分别参与了结构化访谈。
共有11名医生和11名首席执行官参与了该研究。在与医生招聘和留用成功相关的因素类别之间和类别内部发现了差异，其中α社区在社区阿普加问卷指标上得分更高。按受访者类别也注意到了一些差异。在招聘和留用方面历史记录较好的社区，社区阿普加问卷的累积平均得分更高。
基于特定社区的历史劳动力趋势，社区阿普加问卷似乎能够区分具有不同资产和能力的社区。这种评估可能有助于识别可修改和不可修改的因素，也可能表明对于资源有限的社区来说，哪些因素是最需要解决的重要因素。
