Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
J Hosp Med. 2022 Feb;17(2):104-111. doi: 10.1002/jhm.12784.
Hazard pay for resident physicians has been controversial in the COVID-19 pandemic. Program director (PD) beliefs about hazard pay and the extent of provision to internal medicine (IM) residents are unknown.
To evaluate hazard pay provision to residents early in the COVID-19 pandemic and pandemic and residency program characteristics associated with hazard pay.
DESIGN, SETTING, AND PARTICIPANTS: A nationally representative survey was conducted of 429 US/US territory-based IM PDs from August to December 2020.
Hazard pay provision and PD beliefs about hazard pay were tested for association with factors related to the pandemic surge and program characteristics.
Response rate was 61.5% (264/429); 19.5% of PDs reported hazard pay provision. PD belief about hazard pay was equivocal: 33.2% agreed, 43.1% disagreed, and 23.7% were uncertain. Hazard pay occurred more commonly in the Middle-Atlantic Census Division (including New York City) and with earlier surges and greater resident participation in COVID-19 patient care. Hazard pay occurred more commonly where PDs supported hazard pay (74.5% vs. 22.1%, p = .018). Reasons most frequently given in support of hazard pay were essential worker status, equity, and schedule disruption. Those opposed cited professional obligation and equity.
Hazard pay for IM residents early in the COVID-19 pandemic was nominal but more commonly associated with heavily impacted institutions. Although PD beliefs were mixed, positive belief was associated with provision. The unique role of residents as both essential workers and trainees might explain our varied results. Further investigation may inform future policy, especially in times of crisis.
在 COVID-19 大流行期间，住院医师的危险津贴一直存在争议。项目主任（PD）对危险津贴的看法以及向内科住院医师提供津贴的程度尚不清楚。
评估 COVID-19 大流行早期住院医师的危险津贴发放情况，以及与危险津贴相关的住院医师项目特征。
设计、地点和参与者：对 2020 年 8 月至 12 月期间来自美国/美属领地的 429 名内科 PD 进行了一项全国代表性调查。
对危险津贴的发放情况以及 PD 对危险津贴的看法与大流行高峰期间和项目特征相关的因素进行了关联测试。
应答率为 61.5%（264/429）；19.5%的 PD 报告提供了危险津贴。PD 对危险津贴的看法存在分歧：33.2%的人同意，43.1%的人不同意，23.7%的人不确定。在中大西洋普查区（包括纽约市）以及更早的高峰和住院医师更多地参与 COVID-19 患者护理的情况下，危险津贴更常见。PD 支持危险津贴的情况下，危险津贴更常见（74.5%对 22.1%，p=0.018）。支持危险津贴的最常见理由是作为必要工人的地位、公平和日程中断。反对者则提到了职业义务和公平。
COVID-19 大流行早期内科住院医师的危险津贴数额很少，但与受影响严重的机构更为相关。尽管 PD 的信念存在分歧，但积极的信念与津贴的发放有关。住院医师作为必要工人和受训者的独特角色可能解释了我们的不同结果。进一步的调查可能会为未来的政策提供信息，尤其是在危机时期。
