Mollahaliloðlu Salih, Uðurluoðlu Özgür, Iþýk Oðuz, Kosdak Mustafa, Taþkaya Serap
National Health Policies Board, Minisitry of Health, Ankara, Turkey.
Hacettepe University, Faculty of Economics and Administrative Sciences, Department of Health Care Management, Ankara, Turkey.
Rural Remote Health. 2015 Jul-Sep;15(3):3048. Epub 2015 Jul 29.
An unbalanced geographical distribution of physicians leads to important differences in healthcare outcomes and difficulties in accessing healthcare services in rural areas. As in many other countries in the world, the geographical distribution of physicians in Turkey is unbalanced. Although there has been an increase in the number of physicians in the rural areas of Turkey since the introduction of the Health Transformation Program in 2003, health statistics indicate that significant differences still exist between regions in terms of the population-to-physician ratio. The aim of this study was to determine the factors that affect physicians' decisions about working in rural areas in Turkey.
Overall, 1340 physicians working in urban areas constituted the sample group of this study. A survey method was used to collect the data. The questionnaire, which was used as a data collection tool, included nine questions to gather the opinions of physicians regarding working in rural areas. Variables such as occupational group and financial incentives affecting the physicians' willingness to work in rural areas were analyzed with descriptive statistics, and the answers given according to these variables were compared via t-test and one-way analysis of variance.
Of the sample, 59.9% of the participant physicians were men, and 36.9% were specialists. Opinions of the physicians about working in the rural areas differed significantly by occupational group, marital status and income. Medical residents and general practitioners were more willing to work in rural areas than other profession groups. In addition, single physicians were more open to working in rural areas than were married physicians. An increase in physicians' income reduced their willingness to work in rural areas. The developmental level of the region where they worked was found to be a very important variable affecting their preferences. Participants working in developed regions are reluctant to work in the rural areas.
Specific occupational groups, young and single physicians, and physicians working in underdeveloped regions were found to be the groups that can more easily be motivated to work in rural areas. To encourage physicians to work in rural areas, monetary and non-monetary incentives should be considered.
医生的地理分布不均衡会导致医疗保健结果出现重大差异,并使农村地区在获取医疗服务方面面临困难。与世界上许多其他国家一样,土耳其医生的地理分布也不均衡。自2003年实施健康转型计划以来,土耳其农村地区的医生数量有所增加,但健康统计数据表明,各地区在人口与医生比例方面仍存在显著差异。本研究的目的是确定影响土耳其医生在农村地区工作决策的因素。
总体而言,1340名在城市地区工作的医生构成了本研究的样本组。采用调查方法收集数据。用作数据收集工具的问卷包括九个问题,以收集医生对在农村地区工作的看法。对影响医生在农村地区工作意愿的职业群体和经济激励等变量进行描述性统计分析,并通过t检验和单因素方差分析比较根据这些变量给出的答案。
在样本中,59.9%的参与医生为男性,36.9%为专科医生。医生对在农村地区工作的看法因职业群体、婚姻状况和收入而存在显著差异。医学住院医师和全科医生比其他职业群体更愿意在农村地区工作。此外,单身医生比已婚医生更愿意在农村地区工作。医生收入的增加降低了他们在农村地区工作的意愿。发现他们工作地区的发展水平是影响其偏好的一个非常重要的变量。在发达地区工作的参与者不愿在农村地区工作。
特定职业群体、年轻单身医生以及在欠发达地区工作的医生被发现是更容易被激励到农村地区工作的群体。为鼓励医生在农村地区工作,应考虑货币和非货币激励措施。