宾夕法尼亚州的耳鼻喉科医生作为整骨疗法与对抗疗法外科专科医生执业地点影响的一个范例

Pennsylvania Otolaryngologists as a Model for the Implications of Practice Location of Osteopathic vs Allopathic Surgical Subspecialists.

作者信息

Griffith Shane, Power Anton, Strand Mark

出版信息

J Am Osteopath Assoc. 2017 Sep 1;117(9):553-557. doi: 10.7556/jaoa.2017.109.

DOI:10.7556/jaoa.2017.109

PMID:28846121

Abstract

BACKGROUND

Evidenced-based models should be used to predict future implications of the single accreditation system for graduate medical education. Compared with other states, Pennsylvania has a relatively high number of osteopathic physicians (ie, DOs) and may be used as a model for a health care system with an increased DO presence.

OBJECTIVE

To compare the geographic distribution of otolaryngologist DOs with otolaryngologist allopathic physicians (ie, MDs) in Pennsylvania and identify differences in community size (urban, urbanized, and rural) in which these physicians practice.

METHODS

A list of otolaryngologist practice locations in Pennsylvania was developed using Centers for Medicare and Medicaid Services data, the American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery Masterfile, and the American Medical Association Physician Masterfile. The United States Census data were used to document the general population of those locations. The samples of individual otolaryngologist DOs and MDs were then analyzed by determining where each otolaryngologist practiced, identifying the type of community in which they practiced, and then comparing the percentage of otolaryngologist DOs and MDs who practiced in each community type (urbanized area, urban cluster, and rural). A χ2 analysis was used to determine whether a difference existed in practice location between otolaryngologist DOs and MDs.

RESULTS

Of the 47 otolaryngologist DOs, 32 (70%) practiced in cities with a population of 49,999 or less. More than half (120 of 238) of the otolaryngologist MDs practiced in cities larger than 50,000, and 96 of 238 (40%) practiced in cities with a population of at least 200,000. χ2 analysis showed a significant difference in the geographic distribution of otolaryngologist DOs and MDs (P=.012).

CONCLUSION

A correlation exists between the practice location of otolaryngologists in Pennsylvania and the medical degree they hold.

摘要

背景

应使用循证模型来预测毕业后医学教育单一认证系统的未来影响。与其他州相比，宾夕法尼亚州的整骨疗法医生（即骨病医生）数量相对较多，可作为骨病医生数量增加的医疗保健系统的一个模型。

目的

比较宾夕法尼亚州耳鼻喉科骨病医生与耳鼻喉科全科医生（即医学博士）的地理分布，并确定这些医生执业的社区规模（城市、城市化和农村）差异。

方法

利用医疗保险和医疗补助服务中心的数据、美国眼耳鼻喉科 - 头颈外科整骨医学院主文件以及美国医学协会医生主文件，编制宾夕法尼亚州耳鼻喉科医生执业地点清单。使用美国人口普查数据记录这些地点的总人口。然后，通过确定每位耳鼻喉科医生的执业地点、识别他们执业的社区类型，接着比较在每种社区类型（城市化地区、城市集群和农村）执业的耳鼻喉科骨病医生和医学博士的百分比，对个体耳鼻喉科骨病医生和医学博士样本进行分析。采用χ²分析来确定耳鼻喉科骨病医生和医学博士在执业地点上是否存在差异。

结果

在47名耳鼻喉科骨病医生中，32名（70%）在人口为49,999或更少的城市执业。超过一半（238名中的120名）的耳鼻喉科医学博士在人口超过50,000的城市执业，238名中的96名（40%）在人口至少为200,000的城市执业。χ²分析显示，耳鼻喉科骨病医生和医学博士的地理分布存在显著差异（P = 0.012）。