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毕业后医学教育与基层医疗劳动力:一项CERA研究。

Graduate medical education and primary care workforce: a CERA study.

作者信息

Carek Peter J, Peterson Lars, Shokar Navkiran K, Johnson Sharleen P, Knoll Michelle E, Mainous Arch G

机构信息

Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29406, USA.

出版信息

Fam Med. 2012 Nov-Dec;44(10):712-5.

Abstract

BACKGROUND

In the next 10 to 15 years, the Association of American Medical Colleges (AAMC) estimates a shortage of physicians. In conjunction, the demand for primary care physicians will increase, the type of physician associated with better population health at lower health care costs. The objective of this study is to examine the opinions of family medicine residency directors (FMRD) regarding the potential impact of recent publicized recommendations on the primary care physician workforce in the United States.

METHODS

This project is part of a larger CERA omnibus survey with survey methods and sample demographics presented previously. Additional analysis was conducted using chi square and logistic regression using type of residency, size of community, years as program director, year program began, gender, and geographic region as predictors of agreement.

RESULTS

A large proportion of responding FMRD disagree or strongly disagree that increasing medical school size or number of total resident positions in all specialties would result in an increase in the number of medical school graduates choosing a career in primary care Most respondents feel that increasing compensation for those practicing in primary care would have greatest impact on increasing medical school graduates who choose primary care. A minority of responding directors feel the length of family medicine residency training should be 4 years.

DISCUSSION

While numerous recommendations have recently been made, most responding FMRD feel that changing reimbursement for primary care physicians would have the greatest impact on the workforce.

摘要

背景

美国医学院协会(AAMC)估计,在未来10至15年,医生将出现短缺。与此同时,对初级保健医生的需求将会增加,这类医生能以较低的医疗成本带来更好的人群健康状况。本研究的目的是调查家庭医学住院医师培训项目主任(FMRD)对近期公布的建议对美国初级保健医生劳动力的潜在影响的看法。

方法

该项目是一项更大规模的CERA综合调查的一部分,此前已介绍过调查方法和样本人口统计学特征。使用卡方检验和逻辑回归进行了额外分析,将住院医师培训类型、社区规模、担任项目主任的年限、项目开始年份、性别和地理区域作为一致性的预测因素。

结果

很大一部分回复的FMRD不同意或强烈不同意增加医学院规模或所有专业的住院医师总岗位数量会导致选择初级保健职业的医学院毕业生数量增加。大多数受访者认为,提高初级保健从业者的薪酬对增加选择初级保健的医学院毕业生影响最大。少数回复的主任认为家庭医学住院医师培训时长应为4年。

讨论

虽然最近提出了许多建议,但大多数回复的FMRD认为,改变初级保健医生的报销方式对劳动力的影响最大。

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