医学生对《平价医疗法案》的看法与了解：对美国八所医学院校的调查

Medical Students' Views and Knowledge of the Affordable Care Act: A Survey of Eight U.S. Medical Schools.

作者信息

Winkelman Tyler N A, Lehmann Lisa Soleymani, Vidwan Navjyot K, Niess Meredith, Davey Cynthia S, Donovan Derek, Cofrancesco Joseph, Mallory Mia, Moutsios Sandi, Antiel Ryan M, Song John Y

机构信息

Internal Medicine & Pediatrics (Med-Peds) Residency Program, University of Minnesota Medical School, 420 Delaware St SE, Variety Club Research Center - Suite 131, MMC 913, Minneapolis, MN, 55455, USA,

出版信息

J Gen Intern Med. 2015 Jul;30(7):1018-24. doi: 10.1007/s11606-015-3267-9. Epub 2015 Mar 10.

DOI:10.1007/s11606-015-3267-9

PMID:25753386

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4471037/

Abstract

BACKGROUND

It is not known whether medical students support the Affordable Care Act (ACA) or possess the knowledge or will to engage in its implementation as part of their professional obligations.

OBJECTIVE

To characterize medical students' views and knowledge of the ACA and to assess correlates of these views.

DESIGN

Cross-sectional email survey.

PARTICIPANTS

All 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 52% [2,761/5,340]).

MAIN MEASURES

Level of agreement with four questions regarding views of the ACA and responses to nine knowledge-based questions.

KEY RESULTS

The majority of respondents indicated an understanding of (75.3%) and support for (62.8%) the ACA and a professional obligation to assist with its implementation (56.1%). The mean knowledge score from nine knowledge-based questions was 6.9 ± 1.3. Students anticipating a surgical specialty or procedural specialty compared to those anticipating a medical specialty were less likely to support the legislation (OR = 0.6 [0.4-0.7], OR = 0.4 [0.3-0.6], respectively), less likely to indicate a professional obligation to implement the ACA (OR = 0.7 [0.6-0.9], OR = 0.7 [0.5-0.96], respectively), and more likely to have negative expectations (OR = 1.9 [1.5-2.6], OR = 2.3 [1.6-3.5], respectively). Moderates, liberals, and those with an above-average knowledge score were more likely to indicate support for the ACA (OR = 5.7 [4.1-7.9], OR = 35.1 [25.4-48.5], OR = 1.7 [1.4-2.1], respectively) and a professional obligation toward its implementation (OR = 1.9 [1.4-2.5], OR = 4.7 [3.6-6.0], OR = 1.2 [1.02-1.5], respectively).

CONCLUSIONS

The majority of students in our sample support the ACA. Support was highest among students who anticipate a medical specialty, self-identify as political moderates or liberals, and have an above-average knowledge score. Support of the ACA by future physicians suggests that they are willing to engage with health care reform measures that increase access to care.

摘要

背景

尚不清楚医学生是否支持《平价医疗法案》（ACA），或者是否具备将参与该法案实施视为其职业义务一部分的知识或意愿。

目的

描述医学生对《平价医疗法案》的看法和知识，并评估这些看法的相关因素。

设计

横断面电子邮件调查。

参与者

美国八所地理位置各异的医学院校的所有5340名医学生（总体回复率52%[2761/5340]）。

主要测量指标

对关于《平价医疗法案》看法的四个问题的认同程度，以及对九个基于知识问题的回答。

关键结果

大多数受访者表示理解（75.3%）并支持（62.8%）《平价医疗法案》，以及有协助其实施的职业义务（56.1%）。九个基于知识问题的平均知识得分是6.9±1.3。与预期从事内科专业的学生相比，预期从事外科专业或程序性专业的学生支持该立法的可能性较小（OR分别为0.6[0.4 - 0.7]和0.4[0.3 - 0.6]），表明有实施《平价医疗法案》职业义务的可能性较小（OR分别为0.7[0.6 - 0.9]和0.7[0.5 - 0.96]），且有负面预期的可能性较大（OR分别为1.9[1.5 - 2.6]和2.3[1.6 - 3.5]）。温和派、自由派以及知识得分高于平均水平的学生更有可能表示支持《平价医疗法案》（OR分别为5.7[4.1 - 7.9]、35.1[25.4 - 48.5]、1.7[1.4 - 2.1]）以及对其实施负有职业义务（OR分别为1.9[1.4 - 2.5]、4.7[3.6 - 6.0]、1.2[1.02 - 1.5]）。