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澳大利亚培养卫生专业人员的实际成本:培养一支营养师队伍的成本与培养一支牙科专业队伍的成本一样高。

The real cost of training health professionals in Australia: it costs as much to build a dietician workforce as a dental workforce.

作者信息

Segal Leonie, Marsh Claire, Heyes Rob

机构信息

1 Foundation Chair, Health Economics and Social Policy Group, Centre for Population Health Research, University of South Australia, Australia.

2 Research Assistant, Health Economics and Social Policy Group, Centre for Population Health Research, University of South Australia, Australia.

出版信息

J Health Serv Res Policy. 2017 Apr;22(2):91-98. doi: 10.1177/1355819616668202. Epub 2016 Oct 6.

Abstract

Objectives We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. Methods The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out. Census data were used to identify the number of qualified professionals working in their profession over a working life and to model expected years of practice by discipline. Data were combined to estimate the mean cost of training a health professional per year of service in their occupation. Results General medical graduates were the most expensive to train at $451,000 per completing student and a mean cost of $18,400 per year of practice (expected 24.5 years in general practice), while dentistry also had a high training cost of $352,180 but an estimated costs of $11,140 per year of practice (based on an expected 31.6 years in practice). Training costs are similar for dieticians and podiatrists, but because of differential workforce retention (mean 14.9 vs 31.5 years), the cost of training per year of clinical practice is twice as high for dieticians ($10,300 vs. $5200), only 8% lower than that for dentistry. Conclusions Return on investment in training across professions is highly variable, with expected time in the profession as important as the direct training cost. These results can indicate where increased retention and/or attracting trained professionals to return to practice should be the focus of any supply expansion versus increasing the student cohort.

摘要

目标 我们探究了澳大利亚一系列初级卫生保健专业培训劳动力的实际成本,重点关注留用情况的影响,以促进关于如何实现最佳卫生人力组合的辩论。方法 培训一名入门级卫生专业人员在12个学科的成本来自大学学费、临床实习费用,以及在相关情况下的实习成本,并针对学生辍学情况进行了调整。人口普查数据用于确定在职业生涯中从事其专业工作的合格专业人员数量,并按学科对预期执业年限进行建模。将数据结合起来估计培训一名卫生专业人员在其职业中每年服务的平均成本。结果 普通医学毕业生的培训成本最高,每名完成学业的学生为45.1万美元,每年执业的平均成本为1.84万美元(预计在普通执业中为24.5年),而牙科的培训成本也很高,为35.218万美元,但估计每年执业成本为1.114万美元(基于预期执业31.6年)。营养师和足病医生的培训成本相似,但由于劳动力留用情况不同(平均分别为14.9年和31.5年),营养师每年临床实践的培训成本是足病医生的两倍(1.03万美元对5200美元),仅比牙科低8%。结论 各专业培训的投资回报率差异很大,职业预期时间与直接培训成本同样重要。这些结果可以表明,在任何供应扩张中,增加留用率和/或吸引受过培训的专业人员重返执业岗位应成为重点,而不是增加学生人数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4148/5347354/0aadace30a23/10.1177_1355819616668202-fig1.jpg

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