Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Soc Sci Med. 2012 Sep;75(5):801-6. doi: 10.1016/j.socscimed.2012.05.005. Epub 2012 May 26.
Recent policy recommendations have called for increased research efforts to inform the design of cost-effective interventions to address the shortage of health workers in rural areas. This paper takes forward the recent use of Discrete Choice Experiments to assess the effects of potential incentives to attract nurses to rural areas. The analysis relies on data collected in South Africa between August and November 2008. Effectiveness measures derived from Discrete Choice Experiments are combined in a Markov model to derive the long-term effects of policies, and costs are evaluated with secondary data. Measures involving the selection of more nursing students who are more likely to accept positions in rural areas are shown to be the most cost-effective interventions. If such policies could not be implemented, the next best options are to offer preferential access to specialist training to nurses willing to work in rural areas.
最近的政策建议呼吁加大研究力度，为设计具有成本效益的干预措施提供信息，以解决农村地区卫生工作者短缺的问题。本文进一步利用离散选择实验来评估吸引护士到农村地区的潜在激励措施的效果。该分析依赖于 2008 年 8 月至 11 月在南非收集的数据。离散选择实验得出的有效性措施被结合到马尔可夫模型中，以得出政策的长期效果，而成本则使用二手数据进行评估。结果表明，选择更有可能接受农村地区职位的护理专业学生的措施是最具成本效益的干预措施。如果不能实施这些政策，那么次优选择是为愿意在农村地区工作的护士提供优先获得专科培训的机会。
