Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway.
COHERE, Department of Business and Economics, University of Southern Denmark, Denmark.
Soc Sci Med. 2015 Mar;128:1-9. doi: 10.1016/j.socscimed.2014.12.022. Epub 2014 Dec 20.
Shortages of GPs in rural areas constitute a profound health policy issue worldwide. The evidence for the effectiveness of various incentives schemes, which can be specifically implemented to boost recruitment to rural general practice, is generally considered to be poor. This paper investigates young doctors' preferences for key job attributes in general practice (GP), particularly concerning location and income, using a discrete choice experiment (DCE). The subjects were all final year medical students and interns in Norway (N = 1562), of which 831 (53%) agreed to participate in the DCE. Data was collected in November-December 2010. Policy simulations were conducted to assess the potential impact of various initiatives that can be used to attract young doctors to rural areas. Most interestingly, the simulations highlight the need to consider joint policy programs containing several incentives if the policies are to have a sufficient impact on the motivation and likelihood to work in rural areas. Furthermore, we find that increased income seem to have less impact as compared to improvements in the non-pecuniary attributes. Our results should be of interest to policy makers in countries with publicly financed GP systems that may struggle with the recruitment of GPs in rural areas.
农村地区全科医生短缺是一个全球性的深刻卫生政策问题。虽然人们普遍认为，有多种激励措施可以专门用来促进农村地区全科医生的招聘，但这些激励措施的有效性证据却很差。本文使用离散选择实验（DCE）来研究年轻医生对全科医生（GP）关键工作属性（特别是地点和收入）的偏好。研究对象为挪威的应届医学生和实习医生（N=1562），其中 831 名（53%）同意参与 DCE。数据收集于 2010 年 11 月至 12 月。进行了政策模拟，以评估可以吸引年轻医生到农村地区的各种举措的潜在影响。最有趣的是，模拟结果强调，如果政策要对在农村地区工作的动机和可能性产生足够的影响，那么有必要考虑包含多项激励措施的联合政策方案。此外，我们发现，与非金钱属性的改善相比，增加收入的影响似乎较小。我们的研究结果对于那些以公共资金为基础的 GP 系统的国家的政策制定者应该具有一定的参考价值，因为这些国家可能在农村地区招聘全科医生方面存在困难。
