Emil Sherif, Nagurney Justine M, Mok Elise, Prislin Michael D
Department of Pediatric Surgery, Faculty of Medicine, McGill University, Montréal, Que.
Faculty of Medicine, McGill University, Montréal, Que.
CMAJ Open. 2014 Oct 1;2(4):E288-94. doi: 10.9778/cmajo.20130094. eCollection 2014 Oct.
Canada and the United States have similar medical education systems, but different health care systems. We surveyed medical students in Ontario and California to assess their knowledge and views about health care policy and systems, with an emphasis on attitudes toward universal care.
A web-based survey was administered during the 2010-2011 academic year to students in 5 medical schools in Ontario and 4 in California. The survey collected demographic data and evaluated attitudes and knowledge regarding broad health care policy issues and health care systems. An index of support for universal health care was created, and logistic regression models were used to examine potential determinants of such support.
Responses were received from 2241 students: 1354 from Ontario and 887 from California, representing 42.9% of eligible respondents. Support for universal health care coverage was higher in Ontario (86.8%) than in California (51.1%), p < 0.001. In California, females, self-described nonconservatives, students with the intent to be involved in health care policy as physicians and students with a primary care orientation were associated with support for universal coverage. In Ontario, self-described liberals and accurate knowledge of the Canadian system were associated with support. A single-payer system for practice was preferred by 35.6% and 67.4% of students in California and Ontario, respectively. The quantity of instruction on health care policy in the curriculum was judged too little by 73.1% and 57.5% of students in California and Ontario, respectively.
Medical students in Ontario are substantially more supportive of universal access to health care than their California counterparts. A majority of students in both regions identified substantial curricular deficiencies in health care policy instruction.
加拿大和美国有着相似的医学教育体系，但医疗保健体系不同。我们对安大略省和加利福尼亚州的医学生进行了调查，以评估他们对医疗保健政策和体系的了解及看法，重点是对全民医保的态度。
在2010 - 2011学年对安大略省5所医学院和加利福尼亚州4所医学院的学生进行了一项基于网络的调查。该调查收集了人口统计学数据，并评估了关于广泛的医疗保健政策问题和医疗保健体系的态度及知识。创建了一个支持全民医保的指数，并使用逻辑回归模型来检查这种支持的潜在决定因素。
共收到2241名学生的回复：1354名来自安大略省，887名来自加利福尼亚州，占符合条件受访者的42.9%。安大略省对全民医保覆盖的支持率（86.8%）高于加利福尼亚州（51.1%），p < 0.001。在加利福尼亚州，女性、自称非保守派、有意作为医生参与医疗保健政策的学生以及以初级保健为导向的学生与支持全民医保覆盖相关。在安大略省，自称自由派以及对加拿大体系有准确了解的学生与支持相关。加利福尼亚州和安大略省分别有35.6%和67.4%的学生更喜欢单一支付者的执业体系。加利福尼亚州和安大略省分别有73.1%和57.5%的学生认为课程中关于医疗保健政策的教学量太少。
安大略省的医学生比加利福尼亚州的医学生对全民医保的支持程度要高得多。两个地区的大多数学生都指出医疗保健政策教学在课程设置上存在严重不足。
