General Practice and Primary Care, Institute of Health and Wellbeing, Glasgow University, UK.
Medical Directorate, West Region, NHS Education for Scotland, Glasgow, UK.
Fam Pract. 2020 Mar 25;37(2):200-205. doi: 10.1093/fampra/cmz071.
Practice population socioeconomic status is associated with practice postgraduate training accreditation. General Practitioner recruitment to socioeconomically deprived areas is challenging, exposure during training may encourage recruitment.
To determine the association of practice population socioeconomic deprivation score and training status, and if this has changed over time.
Cross-sectional study looking at socioeconomic deprivation and training status for all General Practices in Scotland (n = 982). Data from Information Services Division, from 2015, were combined with the Scottish Index of Multiple Deprivation to calculate weighted socioeconomic deprivation scores for every practice in Scotland. Scottish training body database identified training practices (n = 330). Mean deprivation score for training and non-training practices was calculated. Logistic regression was used to quantify the odds ratio of training status based on deprivation score, adjusted for practice list size, and compared with a similar 2009 analysis.
Socioeconomic deprivation score is associated with training status, but is not significant when adjusted for practice list size [OR (adjusted) 0.87, 95% CI: 0.74-1.04]. In contrast, in 2009, adjusted deprivation score remained significant. Mean deprivation score in training and non-training practices remained similar at both time points [2015: 2.98 (SD 0.88) versus 3.17 (SD 0.81); 2009: 2.95 versus 3.19), with a more deprived mean score in non-training practices.
General practices in affluent areas remain more likely to train, although this association appears to be related to larger practice list sizes rather than socioeconomic factors. To ensure a variety of training environments training bodies should target, and support, smaller practices working in more socioeconomically deprived areas.
实践人群的社会经济地位与实践研究生培训认证相关。向社会经济贫困地区招聘全科医生具有挑战性,培训期间的接触可能会鼓励招聘。
确定实践人群社会经济贫困评分和培训状况之间的关联,以及这种关联是否随时间而变化。
这是一项横断面研究,调查了苏格兰所有全科医生(n=982)的社会经济贫困程度和培训状况。信息服务司的数据与苏格兰多重贫困指数相结合,为苏格兰的每一家实践计算加权社会经济贫困评分。苏格兰培训机构数据库确定了培训实践(n=330)。计算了培训实践和非培训实践的平均贫困评分。使用逻辑回归来量化基于贫困评分的培训状况的优势比,调整了实践清单规模,并与类似的 2009 年分析进行了比较。
社会经济贫困评分与培训状况相关,但在调整实践清单规模后并不显著[调整后的优势比(OR)为 0.87,95%可信区间:0.74-1.04]。相比之下,在 2009 年,调整后的贫困评分仍然显著。培训实践和非培训实践的平均贫困评分在两个时间点都保持相似[2015 年:2.98(SD 0.88)与 3.17(SD 0.81);2009 年:2.95 与 3.19],非培训实践的平均贫困评分更高。
在富裕地区的实践更有可能接受培训,尽管这种关联似乎与更大的实践清单规模而不是社会经济因素有关。为了确保各种培训环境,培训机构应针对并支持在社会经济更贫困地区工作的小型实践。