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国内生産と国際移民:米国の医師労働力の選択肢
1Department of Preventive Medicine, University of Wisconsin Medical School, Madison 53706-1532, USA.
JAMA
|September 25, 1996
まとめ
医者の供給目標を達成するには,大学院医学教育 (GME) のポジションを直ちに削減する必要があります. このモデルは,将来の医師の労働力の調整は,米国で訓練された医学卒業生 (USMGs) や国際医学卒業生 (IMGs),または両方を削減することによって満たすことができることを示しています.
科学分野:
- 医者の労働力モデリング
- 健康経済学 医療経済学
- 医療教育政策 医療教育政策について
背景:
- 将来の医師の供給を予測することは,医療計画において極めて重要です.
- 現在の医師の供給モデルは,国内外の医学の卒業生の両方を考慮する必要があります.
- 医学研究生教育 (GME) は,医師の労働力構成の重要な決定要因である.
研究 の 目的:
- 米国医学部卒業生 (USMGs),国際医学部卒業生 (IMG) 移民,およびGMEのポジションを減らすための代替戦略をモデル化する.
- 医者の供給を将来の医者と人口の比率の目標と整合させる.
- 医者の労働力の安定性に対する異なる減量組合せの影響を分析する.
主な方法:
- 医者の供給の人口予測モデルを開発した.
- アメリカ医学協会の医師マスターファイルのデータと現在の供給予測を使用してモデルを校正しました.
- バックキャストの年間GMEの投入は,将来の供給目標に基づいて,IMGが米国の労働力に入らないことを調整します.
主要な成果:
- 目標レベルでの医師対人口比の安定化には,低減率のため,50年かかることがあります.
- 検討されたすべての目標比率は,GMEの総ポジションの即時削減を必要とする.
- USMGとIMGの必要な削減は相互依存しており,米国でのIMG保持率に影響されています.
結論:
- 将来の医師供給の削減は,医師生産のIMGまたはUSMGの構成要素の調整,または両方の組み合わせを通じて達成できます.
- 開発されたモデルは,GMEコンポーネントのさまざまな組み合わせを推定して,医師の供給目標を達成することを可能にします.
- 労働力政策の調整には,効果的な医師の供給安定化のための長期的な計画地平線が必要です.
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