公共政策とプライマリケア医の供給について
1Natividad Medical Center, Department of Family and Community Medicine, University of California-San Francisco.
JAMA
|November 24, 1989
まとめ
訓練プログラムの問題とサブスペシャライゼーションにより,米国におけるプライマリケア医師の数は減少しており,特に農村や都市部の貧しい地域に影響しています. 医者の分配を改善するために,医療教育資金の改革が必要である.
科学分野:
- 公衆衛生は公衆衛生である.
- 医療教育 医療教育について
- 保健医療政策について
背景:
- 米国では,プライマリーケア専門医の割合が低下しています.
- 医者の数は1963年以来2倍以上に増えたが,オフィスベースのプライマリーケア医の比率は国民の人口に減少した.
- この傾向は,農村部と貧困な都市部に不釣り合いな影響を及ぼしています.
研究 の 目的:
- プライマリケア医の減少に寄与する要因を分析する.
- 医療教育への資金提供が初等医療訓練に与える影響を検証する.
- 医師の配給を改善するための改革を提案する.
主な方法:
- 医者の人口統計と専門分野分布の動向の分析.
- 医学教育の資金調達メカニズムと大学院研修助成金の見直し.
- 医者のキャリア選択に影響を与える要因の検討.
主要な成果:
- 一般診療所の減少,家庭医学研修の停滞,サブスペシャライゼーションの増大が主な要因である.
- 若い医師は,非初等医療専門分野を選択する傾向が高まっている.
- 医療教育のサービス収入への依存は,初等医療訓練の資金調達を妨げています.
結論:
- 医療教育への公的資金の改革は極めて重要です.
- 医者の地理的・専門的分布を改善することが必要である.
- これらの問題への対処は,特にサービス不足の地域で,初等医療へのアクセスを確保するために不可欠です.
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