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州の奨学金,借金免除,および関連するプログラム:未発表の安全ネット
D E Pathman1, D H Taylor, T R Konrad
1Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB7590, Chapel Hill, NC 27599, USA. don_pathman@unc.edu
JAMA
|October 24, 2000
まとめ
1990年から1996年の間に,小規模医療従事者に金銭的インセンティブを提供する州プログラムが倍増し,連邦政府のイニシアティブに匹敵する労働力を獲得しました.
科学分野:
- 医療従事者の分布 医療従事者の分布
- 公共衛生政策 公共衛生政策
- 医療へのアクセスイニシアティブ 医療へのアクセスイニシアティブ
背景:
- 州は,1980年代半ばに奨学金や融資返済プログラムなどの財政的インセンティブを拡大し,恵まれない地域における初等医療の不足に対処しました.
- 国家レベルの連携の欠如は,これらの州レベルのプログラムとその成長に対する理解を制限しています.
研究 の 目的:
- 保健医療提供者に対して,サービスが不足している地域でのサービスと引き換えに,財政的支援を提供する,国家資金のプログラムを特定し,記述する.
- これらの州プログラムが米国の医療安全網に与える貢献度を評価する.
主な方法:
- 電話調査,郵便アンケート,利用可能なプログラム文書から得られたデータを活用した横断的,記述的研究.
- 1996年に実施された州のプログラムには,医師,看護師,医師助手,看護婦助産師に,指定されたサービス不足地域でのサービスに対する財政援助を提供していた.
- 連邦のプログラムや地域社会のイニシアチブを除く.
主要な成果:
- 1996年には,82の州プログラム (29の融資返済,29の奨学金,11の融資,8の直接奨励,5の居住者支援) が41の州で運営され,1990年の39から2倍以上に増加しました.
- 1996年には,これらの州プログラムを通じて約1306人の医師と370人の中級実務者が義務を果たしていたと推定されており,これは連邦プログラムと比較できる数である.
- 主要な特徴には,初等医療,州労働力の分配目標,公共資金への依存などが含まれていた.
結論:
- 州が支援するプログラムは,1996年に,連邦政府のイニシアチブに匹敵する規模で初等医療従事者を提供した.
- これらの州プログラムは,米国の医療安全網の重要な構成要素であり,継続的な監視と評価を必要とします.
- 国家イニシアティブは,医療へのアクセスを改善するためのより広範な議論と計画に統合されるべきです.
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