公共政策和提供初级保健医生
1Natividad Medical Center, Department of Family and Community Medicine, University of California-San Francisco.
JAMA
|November 24, 1989
概括
由于培训计划问题和分专业化,美国的初级保健医生人数正在减少,特别影响农村和城市贫困地区. 医疗教育资金的改革是必要的,以改善医生分配.
科学领域:
- 公共卫生 公共卫生
- 医学教育 医学教育
- 医疗保健政策 医疗保健政策
背景情况:
- 在美国,初级保健专业的医生比例正在下降.
- 自1963年以来,医生人数增加了一倍多,但办公室初级保健医生的比例与全国人口的比例有所下降.
- 这一趋势不成比例地影响农村和贫困的城市社区.
研究的目的:
- 分析导致初级保健医生数量下降的因素.
- 检查医疗教育资助对初级保健培训的影响.
- 为改善医生分配提出改革建议.
主要方法:
- 对医生人口统计和专业分布趋势的分析.
- 审查医学教育融资机制和研究生培训补助金.
- 检查影响医生职业选择的因素.
主要成果:
- 一般诊所的下降,停滞的家庭医学培训和增加的分专业化是关键的驱动因素.
- 年轻医生越来越多地选择非初级保健专业.
- 医学教育对服务收入的依赖阻碍了初级保健培训资金.
结论:
- 改革公共医疗教育资金至关重要.
- 需要改善医生的地理和专业分布.
- 解决这些问题对于获得初级保健至关重要,尤其是在服务不足的地区.
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