Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States.
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States; Moi University School of Medicine, Eldoret, Kenya.
Healthc (Amst). 2015 Dec;3(4):185-9. doi: 10.1016/j.hjdsi.2015.10.001. Epub 2015 Oct 23.
Global health experiences evoke a profound awareness of cultural differences, inspire learners to prioritize professional values, and provide a lens for addressing global health care challenges. This study compares the long-term career and practice choices of participants in a 2-month Indiana University-Moi University, Kenya elective from 1989-2013 with those of a control group.
Global health elective (GHE) participants and a random sample of alumni without GHE experience were surveyed on their clinical practice, public health and global health activities.
Responses from 176 former participants were compared with a control group of 177 alumni. GHE participants were more likely than similar controls to provide care to underserved U.S. populations (p=0.037), spend time in global health, public health, and public policy activities (p=0.005) and be involved in global health advocacy (p=0.001). Using multivariable analysis, GHE participants were more likely to be generalists (p<0.05), report that healthcare costs influenced medical decision-making (p<0.05), and provide healthcare outside the U.S. for ≥1 week/year (p<0.001).
Many years out of training, GHE participants were more likely to be generalists working with underserved populations, to be cost-conscious in their healthcare decision-making, and to be involved in global health, public health or public policy.
With the primary care provider shortage and need for greater awareness among providers of healthcare costs, our study shows that that global health experiences may yield broader benefits to the U.S. medical system.
全球健康体验使人深刻认识到文化差异，激励学习者优先重视专业价值观，并为解决全球医疗保健挑战提供一个视角。本研究比较了 1989 年至 2013 年间参加印第安纳大学-莫伊大学肯尼亚选修课程的 2 个月的学员与对照组的长期职业和实践选择。
对全球健康选修课程（GHE）参与者和没有 GHE 经验的随机校友样本进行了关于他们的临床实践、公共卫生和全球卫生活动的调查。
对 176 名前参与者的回应与对照组的 177 名校友进行了比较。与类似的对照组相比，GHE 参与者更有可能为美国服务不足的人群提供医疗服务（p=0.037），花时间从事全球卫生、公共卫生和公共政策活动（p=0.005）并参与全球卫生宣传（p=0.001）。使用多变量分析，GHE 参与者更有可能成为通才（p<0.05），报告医疗成本影响医疗决策（p<0.05），并在美国境外提供医疗服务≥1 周/年（p<0.001）。
在培训多年后，GHE 参与者更有可能成为服务不足人群的通才，在医疗决策中更加关注成本，并参与全球卫生、公共卫生或公共政策。
由于初级保健提供者短缺以及提供者对医疗成本的认识需要提高，我们的研究表明，全球健康体验可能会给美国医疗系统带来更大的好处。
