J.M. Rook is a fourth-year medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois. T.N.A. Winkelman is a clinician-investigator, Hennepin Healthcare, Minneapolis, Minnesota. J.A. Fox is a fourth-year medical student, University of Colorado School of Medicine, Denver, Colorado. J.B. Pierce is a third-year medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois. A.R. Oot is a third-year medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois. J.R. Blum is a third-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York. A.M. Feuerbach is a fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York. A. Shahu is a first-year resident in internal medicine, Johns Hopkins Hospital, Baltimore, Maryland. M.L. Goldman is a first-year resident in internal medicine, University of California, San Francisco, San Francisco, California. Z. Kopp is a first-year resident in internal medicine, University of California, San Francisco, San Francisco, California. E. Duffy is a first-year resident in internal medicine, Johns Hopkins Hospital, Baltimore, Maryland. T. Robledo-Gil is a first-year resident in internal medicine and urban health, Johns Hopkins Hospital, Baltimore, Maryland. N. Tran is a first-year resident in family medicine, University of California, San Francisco, San Francisco, California. C.S. Davey is biostatistician, University of Minnesota Clinical and Translational Science Institute, Minneapolis, Minnesota. B.L. Henschen is assistant professor, Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Acad Med. 2019 Sep;94(9):1361-1368. doi: 10.1097/ACM.0000000000002621.
Although medical students will influence the future U.S. health care system, their opinions on the Patient Protection and Affordable Care Act (ACA) have not been assessed since the 2016 presidential election and elimination of key ACA provisions. Understanding medical students' views on health care policy and professional obligations can provide insight into issues that will be shaped by the next generation of physicians.
From October 2017 to November 2017, the authors conducted an electronic survey of medical students from seven U.S. institutions to elicit opinions regarding the ACA and their professional responsibility to address health policy. Participant demographics and responses were tabulated, and multiple logistic regression models were used to assess the associations of demographic characteristics with student opinions.
Completed surveys were returned by 1,660/4,503 (36.9%) eligible medical students. Respondent demographics were similar to national estimates. In total, 89.1% (1,475/1,660) supported the ACA, and 82.0% (1,362/1,660) reported that they understood the health care law. Knowledge of the law's provisions was positively associated with support for the ACA (P < .001). Most students (85.8%; 1,423/1,660) reported addressing health policy to be a professional responsibility. Political affiliation was consistently associated with student opinions.
Most medical students support the ACA, with greater levels of support among medical students who demonstrated higher levels of objective knowledge about the law. Furthermore, students indicated a professional responsibility to engage in health policy, suggesting that tomorrow's physicians are likely to participate in future health care reform efforts.
尽管医学生将影响未来的美国医疗保健体系，但自 2016 年总统选举和关键 ACA 条款的废除以来，他们对《患者保护与平价医疗法案》（ACA）的看法尚未得到评估。了解医学生对医疗政策和专业责任的看法，可以深入了解将由下一代医生塑造的问题。
2017 年 10 月至 11 月，作者对来自美国七所机构的医学生进行了电子调查，以了解他们对 ACA 的看法以及他们解决卫生政策的专业责任。对参与者的人口统计学特征和反应进行了制表，并使用多项逻辑回归模型评估了人口统计学特征与学生意见之间的关联。
完成的调查由 1660/4503（36.9%）名符合条件的医学生返回。应答者的人口统计学特征与全国估计值相似。共有 89.1%（1475/1660）的人支持 ACA，82.0%（1362/1660）的人报告他们了解医疗保健法。对法律规定的了解与对 ACA 的支持呈正相关（P<.001）。大多数学生（85.8%；1423/1660）报告将解决卫生政策作为专业责任。政治派别始终与学生意见相关。
大多数医学生支持 ACA，对法律知识水平较高的医学生的支持率更高。此外，学生表示有参与卫生政策的专业责任，这表明未来的医生可能会参与未来的医疗保健改革工作。
