Kindig D A, Movassaghi H, Dunham N C, Zwick D I, Taylor C M
Inquiry. 1987 Summer;24(2):136-46.
The overall growth in the physician supply has so dominated the public policy agenda that issues of physician distribution within urban areas have received little attention. In this study, we examined the changes in physician availability in the poverty and nonpoverty areas of 10 U.S. cities between 1963 and 1980. We found that the overall availability of patient care physicians increased in both poverty and nonpoverty areas, with greater growth in the nonpoverty areas. For office-based primary care physicians, however, there was a 45% decline in availability in the poverty areas and a 27% decline in the nonpoverty areas. We conclude that the overall increase in the physician supply may not adequately correct geographic and specialty maldistribution in urban areas. We suggest that special educational, service delivery, and financing strategies within urban areas continue to be needed to address problems of inequitable physician availability.
医生供给的总体增长在公共政策议程中占据了主导地位，以至于城市地区内医生分布的问题很少受到关注。在本研究中，我们考察了1963年至1980年间美国10个城市贫困和非贫困地区医生可及性的变化。我们发现，贫困和非贫困地区提供患者护理的医生总体可及性均有所增加，非贫困地区增长幅度更大。然而，对于基于诊所的初级保健医生而言，贫困地区的可及性下降了45%，非贫困地区下降了27%。我们得出结论，医生供给的总体增加可能无法充分纠正城市地区地理和专业分布不均的问题。我们建议，仍需要在城市地区采取特殊的教育、服务提供和融资策略，以解决医生可及性不平等的问题。
