国家奖学金,贷款赦免和相关计划:未知的安全网
D E Pathman1, D H Taylor, T R Konrad
1Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB7590, Chapel Hill, NC 27599, USA. don_pathman@unc.edu
JAMA
|October 24, 2000
概括
在1990年至1996年期间,为服务不足地区的初级保健从业者提供财政激励的州政府计划翻了一番,提供与联邦计划相匹配的劳动力.
科学领域:
- 医疗卫生工作人员的分布.
- 公共卫生政策 公共卫生政策
- 医疗保健获取倡议 医疗保健获取倡议
背景情况:
- 20世纪80年代中期,各州扩大了奖学金和贷款偿还计划等财政激励措施,以解决服务不足地区的初级保健短缺问题.
- 由于缺乏国家协调,对这些州级计划及其增长的理解有限.
研究的目的:
- 识别和描述提供财政支持给医疗保健提供者,以换取服务在服务不足的地区的国家资助的计划.
- 评估这些州计划对美国医疗保健安全网的贡献.
主要方法:
- 一个横截面的描述性研究,利用来自电话调查,邮件问卷和可用的程序文档的数据.
- 包括1996年运行的国家计划,为医生,执业护士,医生助理和护士助产士在指定服务不足的地区提供服务的财政援助.
- 不包括联邦计划和当地社区倡议.
主要成果:
- 1996年,82个州计划 (29个贷款还款,29个奖学金,11个贷款,8个直接激励,5个居民支持) 在41个州运行,比1990年的39个增加了一倍多.
- 据估计,1996年有1306名医生和370名中级从业人员通过这些州计划履行义务,这个数字与联邦计划相当.
- 主要特点包括重点关注初级保健,国家劳动力分配目标和依赖公共资金.
结论:
- 国家资助的计划在1996年提供了与联邦计划相美的大小的初级保健工作人员.
- 这些州级计划是美国医疗保健安全网的重要组成部分,需要持续监测和评估.
- 国家举措应纳入更广泛的讨论和规划,以改善医疗保健的获取.
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