Connor R A, Hillson S D, Kralewski J E
Division of Health Management and Policy, University of Minnesota School of Public Health (UMSPH), Minneapolis 55455-0381.
Acad Med. 1994 Jun;69(6):483-8. doi: 10.1097/00001888-199406000-00016.
To analyze the association between rural hospitals' participation in residency training and their subsequent success in physician recruitment and retention.
The units of observation were 1,789 short-term, general hospitals that were located in nonmetropolitan U.S. countries, had medical staff information available, and did not close, open, or merge from 1985 through 1989. Multivariate analysis was done using ordinary least-squares estimation. The dependent variable was the change in the size of the medical staff at each hospital. Several characteristics of the hospitals and their counties were used as independent variables, the primary one being the number of housestaff at each hospital in 1985.
The 66 rural hospitals that invested in housestaff were found to be more successful in physician recruitment and retention in subsequent years. On average, for every eight housestaff in 1985, each hospital gained approximately one additional physician on its medical staff from 1985 through 1989.
The rural hospitals with residencies were more likely to be successful at recruiting and retaining physician staff than were the hospitals without residencies. Because most of the residencies were probably in primary care specialties, this finding is suggestive in light of the national need for primary care training as well as for successful recruiting strategies for rural hospitals.
分析农村医院参与住院医师培训与其随后在医生招聘和留用方面的成功之间的关联。
观察单位为1789家短期综合医院，这些医院位于美国非大都市地区的县，有医务人员信息，且在1985年至1989年期间未关闭、开业或合并。使用普通最小二乘法估计进行多变量分析。因变量是每家医院医务人员规模的变化。医院及其所在县的几个特征被用作自变量，主要自变量是1985年每家医院的住院医师人数。
发现66家投资于住院医师的农村医院在随后几年的医生招聘和留用方面更成功。平均而言，1985年每有8名住院医师，从1985年到1989年，每家医院的医务人员中就会增加约一名医生。
设有住院医师培训项目的农村医院比没有住院医师培训项目的医院更有可能成功招聘和留住医生。由于大多数住院医师培训项目可能是在初级保健专业，鉴于国家对初级保健培训的需求以及农村医院成功的招聘策略，这一发现具有启示意义。
