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La política pública y el suministro de médicos de atención primaria
1Natividad Medical Center, Department of Family and Community Medicine, University of California-San Francisco.
JAMA
|November 24, 1989
Resumen
El número de médicos de atención primaria en los Estados Unidos está disminuyendo debido a problemas de programas de capacitación y subespecialización, que afectan particularmente a las zonas pobres rurales y urbanas. Se necesitan reformas en la financiación de la educación médica para mejorar la distribución de médicos.
Área de la Ciencia:
- Salud Pública La salud pública.
- Educación médica y educación médica.
- Política de la atención de la salud Política de salud.
Sus antecedentes:
- La proporción de médicos en especialidades de atención primaria en los Estados Unidos está disminuyendo.
- El número de médicos se ha más que duplicado desde 1963, pero la proporción de médicos de atención primaria basados en consultorios con respecto a la población nacional ha disminuido.
- Esta tendencia afecta desproporcionadamente a las comunidades rurales y urbanas empobrecidas.
Objetivo del estudio:
- Analizar los factores que contribuyen a la disminución de los médicos de atención primaria.
- Examinar el impacto de la financiación de la educación médica en la formación de atención primaria.
- Proponer reformas para mejorar la distribución de médicos.
Principales métodos:
- Análisis de la demografía de los médicos y las tendencias de distribución de especialidades.
- Revisión de los mecanismos de financiación de la educación médica y las becas de formación de posgrado.
- Examen de los factores que influyen en las elecciones profesionales de los médicos.
Principales resultados:
- El declive de la práctica general, el estancamiento de la capacitación en medicina familiar y el aumento de la subespecialización son factores clave.
- Los médicos jóvenes están eligiendo cada vez más especialidades de atención no primaria.
- La dependencia de la educación médica de los ingresos por servicios dificulta el financiamiento de la capacitación en atención primaria.
Conclusiones:
- La reforma de la financiación pública de la educación médica es crucial.
- Es necesaria una mejor distribución geográfica y especializada de los médicos.
- Abordar estas cuestiones es vital para el acceso a la atención primaria, especialmente en áreas desatendidas.
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