家庭医学住院医师打算在何处以及如何执业的地区差异：一项横断面调查分析

Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis.

作者信息

Lavergne M Ruth, Scott Ian, Mitra Goldis, Snadden David, Blackie Doug, Goldsmith Laurie J, Rudoler David, Hedden Lindsay, Grudniewicz Agnes, Ahuja Megan A, Marshall Emily Gard

机构信息

Faculty of Health Sciences (Lavergne, Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; Department of Family Practice (Scott, Mitra), Faculty of Medicine, University of British Columbia, Vancouver, BC; Department of Family Practice (Snadden), Faculty of Medicine, University of British Columbia Northern Medical Program, Prince George, BC; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; University of Ontario Institute of Technology (Rudoler), Oshawa, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Centre for Health Services and Policy Research (Ahuja), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Family Medicine (Marshall), Faculty of Medicine, Dalhousie University, Halifax, NS

出版信息

CMAJ Open. 2019 Feb 28;7(1):E124-E130. doi: 10.9778/cmajo.20180152. Print 2019 Jan-Mar.

DOI:10.9778/cmajo.20180152

PMID:30819692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6397032/

Abstract

BACKGROUND

Family medicine residents choose among a range of practice options as they enter the physician workforce. We describe the demographic and personal characteristics of Canadian family medicine residents and examine differences in the intentions of residents from Ontario, Quebec, Western Canada and Atlantic Canada at the completion of their training, in terms of practice comprehensiveness, organizational model, clinical domains, practice settings and populations served.

METHODS

We analyzed national survey data collected by the College of Family Physicians of Canada and 16 university-based family medicine residency programs. We tabulated bivariable descriptive results and used logistic regression to estimate odds of practice intentions across regions, adjusting for family medicine resident characteristics.

RESULTS

Of 1680 respondents (61.5% of 2731 family medicine residents invited to participate), 66.3% ( = 1095) reported it was somewhat or highly likely they would commit to providing comprehensive care to the same group of patients within their first 3 years of practice. This percentage varied from 40.3% in Atlantic Canada to 85.1% in Ontario. In addition, 31.5% ( = 522) reported it was somewhat or highly likely they would focus only on specific clinical areas. Most respondents reported it was somewhat or highly likely that they would practise in a group physician practice (93.8%) or interprofessional team-based practice (88.1%), and only 7.7% expected to have a solo practice.

INTERPRETATION

Intentions for comprehensive and focused practice varied, but over 80% of family medicine residents indicated they intended to practise in a team-based model in all regions. Policy-makers and workforce planners should consider the impact of family medicine residents' intentions on policy objectives.

摘要

背景

家庭医学住院医师在进入医师队伍时会在一系列执业选择中做出抉择。我们描述了加拿大家庭医学住院医师的人口统计学和个人特征，并考察了安大略省、魁北克省、加拿大西部和加拿大大西洋地区的住院医师在培训结束时，在执业全面性、组织模式、临床领域、执业环境和服务人群方面的意向差异。

方法

我们分析了加拿大家庭医生学院和16个大学附属家庭医学住院医师项目收集的全国性调查数据。我们列出了双变量描述性结果，并使用逻辑回归来估计各地区执业意向的几率，同时对家庭医学住院医师的特征进行了调整。

结果

在1680名受访者（受邀参与的2731名家庭医学住院医师中的61.5%）中，66.3%（=1095）表示他们在执业的前3年内很有可能或非常有可能致力于为同一组患者提供全面护理。这一比例在加拿大大西洋地区为40.3%，在安大略省为85.1%。此外，31.5%（=522）表示他们很有可能或非常有可能只专注于特定临床领域。大多数受访者表示他们很有可能或非常有可能在集体医师执业模式（93.8%）或跨专业团队执业模式（88.1%）下执业，只有7.7%的人期望独立执业。