医疗培训计划的规模和临床工作人员的生产力和流动性
Kertu Tenso1,2, Yufei Li1,2, Aaron Legler1
1Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts, USA.
Health services research
|July 24, 2024
概括
居民培训计划的大小会影响退伍军人卫生管理局 (VHA) 中的临床医师生产率和营业额. 较大的计划可能会降低某些专业的生产率,但会增加其他专业的生产率,特别是在短缺地区.
科学领域:
- 医学教育 医学教育
- 医疗保健服务研究 医疗服务研究
- 临床医生的生产力
背景情况:
- 退伍军人卫生管理局 (VHA) 是美国主要的医疗培训平台.
- 了解培训计划规模对临床医生的生产力和营业额的影响,对于医疗保健系统的效率至关重要.
研究的目的:
- 评估居民计划培训规模对VHA内临床医生的生产力和营业额的影响.
- 分析这些影响如何因专业和地理区域而异.
主要方法:
- 采用了一种准实验性的仪器变量2SLS设计.
- 分析了来自26个专业的141个VHA设施 (2011-2021) 的国家行政数据.
- 二次分析按卫生专业人员短缺地区 (HPSA) 分层结果.
主要成果:
- 培训时间增加与生产率下降 (每天访问次数减少0.039) 和营业额增加 (0.02个百分点) 相联系.
- 影响因专业而异:精神病学/心理学发现生产率下降,而初级保健/心脏病学发现生产率增加.
- 负面影响集中在没有初级保健医生短缺的地区;短缺地区的生产率增加,营业额没有变化.
结论:
- 住院培训计划的大小影响了VHA的临床医生的生产力和营业额.
- 专业和HPSA状态修改了这些影响,一些地区从更大的计划中受益.
- 结果表明,针对优化培训计划规模的有针对性的策略,基于专业和当地需求.
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