Rieder M J, Hanmer S J, Haslam R H
Department of Paediatrics, Children's Hospital of Western Ontario, University of Western Ontario, London, Canada.
Pediatrics. 1990 Feb;85(2):144-9.
The desire to control health care costs in Canada has led to reductions in postgraduate training posts and physician immigration. To determine the possible effects of these cutbacks on pediatric manpower, a country-wide study was conducted to assess the practice patterns and productivity of Canadian pediatricians. Of the 1960 pediatricians in Canada, 69% completed and returned our questionnaire. Practice descriptions were as follows: 37% practice primary, 25% secondary, and 38% tertiary care. A total of 70% of Canadian pediatricians are men, although this will change with time because 49% of pediatricians younger than 35 years of age are women. Clinical productivity was assessed by five indices: number of clinical hours, patients seen, consultations provided, and hours on call per week, and number of hospital admissions per year. Younger pediatricians were significantly less clinically productive than older pediatricians. Age-matched groups of female pediatricians were significantly less clinically productive than their male counterparts in three of the five indices assessed. Overall, female pediatricians were significantly more likely to work part-time than were male pediatricians (22% vs 16%, P less than .05). When the clinical productivity of part-time pediatricians was assessed, there was no male to female difference noted. However, among full-time pediatricians, men worked significantly more clinical hours per week and saw significantly more patients than did women (P less than .05). According to results, women pediatricians were more satisfied with their practice now than when starting practice than were men (47% vs 41%).(ABSTRACT TRUNCATED AT 250 WORDS)
加拿大控制医疗保健成本的愿望导致了研究生培训岗位的减少和医生移民数量的下降。为了确定这些削减措施对儿科人力可能产生的影响,我们开展了一项全国性研究,以评估加拿大儿科医生的执业模式和工作效率。在加拿大的1960名儿科医生中,69%完成并返还了我们的调查问卷。执业情况描述如下:37%从事初级保健,25%从事二级保健,38%从事三级保健。加拿大70%的儿科医生为男性,不过随着时间推移这一情况将会改变,因为35岁以下的儿科医生中有49%为女性。通过五个指标评估临床工作效率:临床工作小时数、诊治患者数量、提供的会诊次数、每周值班小时数以及每年的住院患者收治数量。年轻儿科医生的临床工作效率显著低于年长儿科医生。在评估的五个指标中的三个指标上,年龄匹配的女性儿科医生组的临床工作效率显著低于男性同行。总体而言,女性儿科医生比男性儿科医生更有可能从事兼职工作(22%对16%,P<0.05)。在评估兼职儿科医生的临床工作效率时,未发现男女差异。然而,在全职儿科医生中,男性每周的临床工作小时数显著多于女性,诊治的患者数量也显著多于女性(P<0.05)。根据结果,女性儿科医生对其目前执业状况的满意度高于刚开始执业时,高于男性(47%对41%)。(摘要截选至250词)