医科大学院教育改革について. サービス提供の移行コスト
J J Stoddard1, D A Kindig, D Libby
1Department of Pediatrics, University of Wisconsin-Madison Medical School 53706-1532.
JAMA
|July 6, 1994
まとめ
医科大学院教育の改革は,長期的に大きな節約につながるかもしれないが,初期費用を負うことになる. ハウススタッフの置換は,教科病院に年間14億から18億ドルの費用がかかると予測されています.
科学分野:
- 健康経済学とは
- 医療教育政策 医療教育政策について
- 医療従事者の分析
背景:
- 現在の大学院医学教育 (GME) のシステムは,その費用対効果と効率性に関して,精査に直面しています.
- GMEの改革は,教科病院内のトレーニングとリソースの割り当てを最適化するために検討されています.
- GME改革が成功するためには,家事スタッフの置換による財政的影響を理解することが不可欠です.
研究 の 目的:
- 改革されたGMEシステムにおいて,ハウススタッフ (レジデントとフェロー) の置換のための潜在的な戦略を分析する.
- 米国の教科病院におけるこれらの置換戦略の関連コストを推定する.
- GME改革を検討している政策立案者や病院管理者に経済的な洞察を提供するためです.
主な方法:
- 家事スタッフの置換のための2つの異なるシナリオをシミュレートするために,経済モデルが開発されました.
- シナリオ1:非医師の提供者,スタッフ医師,看護師,および補助スタッフを含む低コストモデル.
- シナリオ2:より高いコストの従来のモデルで,スタッフ医師に大きく依存する.
- このモデルでは,正社員1人当たりの純置換コストと,国内総コストの見積もりを予測した.
主要な成果:
- 年間純置換コストは,低コストモデルではFTEあたり58,000ドル,高コストモデルではFTEあたり77,000ドルと推定された.
- 推定2万3200人の家事スタッフの職が廃止されるため,全国の代替コストは年間14億~18億米ドルと見積もられている.
- これらの数字は,移行期間中に教科病院が負った純コストを表しています.
結論:
- 医科大学院教育の改革は,長期的に大幅なコスト削減の機会をもたらします.
- しかし,サービス提供における移行は,短期的に新たな支出を必要とする.
- 戦略的プランニングは,GME改革とハウススタッフの置換による財政的影響を管理するために不可欠です.
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