Hicks L L
Am J Public Health. 1984 Dec;74(12):1316-21. doi: 10.2105/ajph.74.12.1316.
A model is used to identify counties in Missouri in which the supply of physician services is inadequate to serve the resident population. In the model, a formula is used to assess the gap between the physician services available in a county and the visits which would be required to serve the residents. Incorporated in the model are adjustments for the age and specialty of the physicians and the age and sex of the population. The model is applied to 1976 and 1981 data in order to analyze the changes which have occurred within the state during that time. The results show that in spite of a 34 per cent increase in the number of physicians practicing in Missouri between 1976 and 1981, 24 of the 115 counties in the state experienced a decrease in their ability to serve their resident populations adequately. Of these 24 counties, 23 had populations of less than 25,000 and 12 had populations of less than 10,000. A factor magnifying the underservice problem is the sharp increase in the proportion of older physicians located in small, rural counties. In 1981, 47 per cent of the primary care physicians located in counties with less than 10,000 people were aged 60 and over, compared to 34 per cent in 1976. This portends major problems in the future in obtaining replacements.
一个模型被用来识别密苏里州内医生服务供应不足以服务当地居民的县。在该模型中，一个公式被用来评估一个县可获得的医生服务与服务居民所需就诊次数之间的差距。该模型纳入了对医生年龄和专业以及人口年龄和性别的调整。该模型应用于1976年和1981年的数据，以便分析该州在此期间发生的变化。结果表明，尽管1976年至1981年期间在密苏里州执业的医生数量增加了34%，但该州115个县中有24个县为当地居民提供充分服务的能力下降了。在这24个县中，23个县的人口不到25000人，12个县的人口不到10000人。一个加剧服务不足问题的因素是位于农村小县的老年医生比例急剧增加。1981年，在人口不到10000人的县中，47%的初级保健医生年龄在60岁及以上，而1976年这一比例为34%。这预示着未来在寻找替代人员方面将出现重大问题。
