Machala M, Miner M W
Eccles Graduate School of Business, University of Utah, Salt Lake City 84112.
Public Health Rep. 1994 May-Jun;109(3):441-5.
The problem of physicians dropping the practice of obstetrics is becoming more serious each year in the United States. Those who remain in practice are increasingly reluctant to serve women who receive Medicaid assistance. Previous research has tended to focus on low reimbursement and liability as barriers that physicians perceive to providing prenatal care to low-income clients. In a 1992 survey in rural Idaho, however, physicians who have been serving these clients for at least 4 years rated other factors equally or more important in treating low-income women. These other factors, discussed in this paper, have to do with the administrative and psychosocial support coordinated by public health nurses for their internal clients, the physicians, as well as for their external clients, pregnant women.
在美国，产科医生放弃产科业务的问题逐年变得更加严重。仍从事该业务的医生越来越不愿意为接受医疗补助的女性提供服务。以往的研究往往将低报销率和责任视为医生认为为低收入客户提供产前护理的障碍。然而，在1992年爱达荷州农村的一项调查中，为这些客户服务至少4年的医生认为，在治疗低收入女性方面，其他因素同样重要或更重要。本文所讨论的这些其他因素，与公共卫生护士为其内部客户（医生）以及外部客户（孕妇）协调的行政和心理社会支持有关。
