まとめ
新しいモデルは,大学院医学教育 (GME) を経由した医師の流れを追跡します. ファミリー・プラクティス・レジデントの数が増えることは,GMEプログラムでの減退率が低いため,プライマリケア・プラクティシャンを増やしています.
科学分野:
- 医療教育 医療教育について
- 医療労働力分析 分析
- 医者の分布モデリング
背景:
- レジデントの進歩のダイナミクスを理解することは,将来の医師の労働力を形作る上で極めて重要です.
- アメリカ医学会 (American Medical Association) の医師のマスターファイルは,キャリアの軌道を分析するための豊富なデータセットを提供します.
研究 の 目的:
- 医科大学院教育 (GME) システムを通じた居住者の流れを説明するモデルを開発・分析する.
- 初期レジデンス専門分野分布と最終的な医師専門分野分布の関係を調査する.
主な方法:
- 米国医学部卒業生16万名 (1960年−1977年) の匿名のGME履歴を利用した.
- アメリカ医学協会の医師マスターファイル (1979年) から得られたデータ.
- GME内の居住者フローと専門分野の変化を追跡するためのモデルを開発しました.
主要な成果:
- モデルによると,家庭内診療の定員が増えたと,初等医療従事者の数が増えたと相関している.
- ファミリー・プラクティス・レジデンスでは,内科や小児科と比較して,退院率が低いことが示されています.
- 1年目の家庭医学の在職者の増加は,全体的なプライマリケア在職者の減少と関連していたが,内科のサブスペシャリストの増加と外科のサブスペシャリストの減少があった.
結論:
- GMEのエントリー時の居住者の専門分野分布は,実務医の最終的な分布に大きな影響を与えます.
- ファミリー・プラクティス・レジデンシーを通じてプライマリケア医を増やすことを目的とした政策介入は,他の専門分野に複雑な影響を及ぼす可能性があります.
- 専門薬の流通と初等医療の供給に対するGMEシステムの影響を完全に理解するためには,さらなる分析が必要である.
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