Wilkes M S, Skootsky S A, Slavin S, Hodgson C S, Wilkerson L
Center for Educational Development and Research, University of California, Los Angeles, UCLA School of Medicine.
Acad Med. 1994 Apr;69(4):307-9. doi: 10.1097/00001888-199404000-00016.
To study the attitudes of entering first-year medical students toward reform of the U.S. health care system.
All 631 first-year medical students at the five medical schools in the University of California System were asked during orientation (late summer of 1992) to complete a self-administered questionnaire regarding their attitudes toward and knowledge about health care reform. Statistical methods used were chi-square tests and factor analyses.
Of the 631 students, 594 (94%) responded. Of the respondents, 392 (66%) felt that there should be a national health insurance plan, and 428 (72%) felt that practicing physicians had a major responsibility to help reduce health care costs. When asked about specific changes intended to control health care costs, the students identified reform of the medical malpractice system (374, 63%) and increased spending on preventive health (356, 60%) as the most likely to be effective. The students generally held negative attitudes toward managed care organizations; only 59 (10%) indicated they would choose to receive care in health maintenance organizations.
The students held strong opinions about access to care, managed care organizations, and strategies intended to reduce health care spending. Medical educators not only need to find creative methods of introducing these content areas into medical school curricula but should also anticipate the need for strategies to deal with negative attitudes held by students.
研究刚入学的一年级医学生对美国医疗保健系统改革的态度。
在迎新期间（1992年夏末），对加利福尼亚大学系统内五所医学院的所有631名一年级医学生进行调查，要求他们自行填写一份关于其对医疗保健改革的态度和知识的问卷。所采用的统计方法为卡方检验和因子分析。
631名学生中，594名（94%）做出了回应。在这些受访者中，392名（66%）认为应该有一项全国医疗保险计划，428名（72%）认为执业医生对帮助降低医疗保健成本负有主要责任。当被问及旨在控制医疗保健成本的具体变革时，学生们认为医疗事故责任制度改革（374名，63%）和增加预防性健康支出（356名，60%）是最有可能有效的措施。学生们对管理式医疗组织普遍持负面态度；只有59名（10%）表示他们会选择在健康维护组织接受治疗。
学生们对医疗服务的可及性、管理式医疗组织以及旨在减少医疗保健支出的策略持有强烈的观点。医学教育工作者不仅需要找到将这些内容领域引入医学院课程的创新方法，还应预见到应对学生负面态度所需的策略。
