Roos N, Black C, Wade J, Decker K
Department of Community Health Sciences, University of Manitoba, Winnipeg, Man.
CMAJ. 1996 Aug 15;155(4):395-401.
To assess critically the results of using three different approaches to planning for the number of general surgeons in rural areas.
Estimates of the number of general surgeons needed using a ratio approach, a and a population-needs-based approach.
Rural southern Manitoba.
Number of general surgeons needed.
The ratio approach supported the recruitment of 7.8 to 14.5 additional general surgeons to rural southern Manitoba. The repatriation approach suggested that the area might support five additional general surgeons, if residents could be persuaded to undergo their surgery closer to home. The population-needs-based approach suggested that the health status of area residents was similar to that of residents of other areas of the province and that they had a higher rate of surgery than residents of other areas; no additional surgeons were apparently needed.
Each method has certain advantages, and none is necessarily useful in isolation. Hence, the most effective approach to planning for general surgeons is likely a combination of all three methods. Other factors that may be important include the type of payment structure and the need for professional groups to monitor variations in rates of surgery.
严格评估采用三种不同方法规划农村地区普通外科医生数量的结果。
采用比例法、回归法和基于人群需求法估算所需普通外科医生数量。
曼尼托巴省南部农村地区。
所需普通外科医生数量。
比例法支持为曼尼托巴省南部农村地区额外招聘7.8至14.5名普通外科医生。回归法表明,如果能说服住院医生在离家更近的地方接受手术,该地区可能额外支持5名普通外科医生。基于人群需求法表明,该地区居民的健康状况与该省其他地区居民相似,且他们的手术率高于其他地区居民;显然不需要额外的外科医生。
每种方法都有一定优势,单独使用都不一定有用。因此,规划普通外科医生数量最有效的方法可能是将这三种方法结合起来。其他可能重要的因素包括支付结构类型以及专业团体监测手术率差异的必要性。