New York College of Osteopathic Medicine, Old Westbury, New York, United States of America.
PLoS One. 2011;6(9):e23557. doi: 10.1371/journal.pone.0023557. Epub 2011 Sep 13.
Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented.
To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost.
DESIGN, SETTING, AND PARTICIPANTS: An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October-December 2010, with 1232 students responding and a response rate of 18%.
Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items.
Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided.
The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment.
《患者保护与平价医疗法案》（PPACA）通过一年多后，立法者、医疗保健专家、医生和公众仍在继续辩论该法案的影响及其废除问题。PPACA 将对未来的医生产生重大影响，但医学学生对该立法的看法尚未得到很好的记录。
评估医学生对医疗改革和 PPACA 的理解和态度，包括质量、可及性和成本问题。
设计、地点和参与者：2010 年 10 月至 12 月期间，向 10 所医学院的医学生发送了一份匿名电子调查，共有 6982 名学生收到调查，回复率为 18%。
医学生对 PPACA 及相关主题的看法和态度，采用李克特量表和开放式回答项目进行测量。
在所调查的医学生中，94.8%的人认为美国现有医疗保健系统需要改革，31.4%的人认为 PPACA 将改善医疗质量，而 20.9%的人不同意，近一半（47.7%）的人不确定质量是否会提高。三分之二（67.6%）的人认为 PPACA 将增加可及性，6.5%的人不同意，其余 25.9%的人不确定。关于控制医疗成本，45.4%的参与者表示他们不确定 PPACA 的规定是否会做到这一点。总体而言，80.1%的受访者表示支持 PPACA，78.3%的人还表示他们认为改革努力还不够。大多数受访者（58.8%）反对废除 PPACA，而 15.0%的人支持废除，26.1%的人持中立态度。
绝大多数医学生认识到需要进行医疗改革，并表示支持 PPACA，但也对其是否能解决质量或成本控制问题表示担忧。
