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プライマリケアと専門医のキャリア満足度の変化,1997-2001年
Bruce E Landon1, James Reschovsky, David Blumenthal
1Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, Mass 02115, USA. landon@hcp.med.harvard.edu
JAMA
|January 22, 2003
まとめ
医師のキャリア満足度は1997年から2001年の間にわずかに低下し,ほとんどの変化は,収入や管理されたケアではなく,臨床的自律性の低下と労働量の増加に関連しています.
科学分野:
- 医療実践のダイナミクス 医療実践のダイナミクス
- 医者のキャリアトレンド
- 医療サービス 研究 医療サービス
背景:
- 医療分野は過去10年間で大きな変革を遂げています.
- こうした変化の中で,医師の仕事の満足度は低下しているようです.
研究 の 目的:
- 大規模な全国の医師集団のキャリア満足度の変化を分析する.
- 医者の満足度の変化に影響を与える実践と市場要因を調査する.
主な方法:
- コミュニティ・トラッキング・スタディ (CTS) の医師調査の3ラウンド (1996年-2001年) のデータを活用した.
- 患者ケアに週20時間以上働いている初等医療および専門医を含む.
- 総合的なキャリア満足度および職場で特定される不満率の評価された変化.
主要な成果:
- 医者の満足度は1997年から2001年にかけてわずかに減少したが,主に1997年から1999年の間に減少した.
- 60の異なる米国のサイトで,満足度レベルの有意な変動が観察されました.
- 臨床的自律性の低下,労働時間の延長,患者ケア調整の課題は,満足度の低下と密接に関連していた.
結論:
- 総合的な医師の満足度は比較的安定したままであったが,サイト特有の顕著な変動があった.
- 満足度に影響を与えた要因は,医師の自律性と医療の質に対する脅威であった.
- マネージドケアへの曝露の変化は,医師の満足度の変化と弱い相関関係を示した.
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