美国内科医生住院计划中的医生中社区的种族和民族代表性
Jung G Kim1,2, Elle Lett3, Christy K Boscardin4
1Ronald O. Perelman Department of Emergency Medicine, New York University Langone Health, New York.
JAMA network open
|January 30, 2025
概括
与社区相比,在内科住院计划中,医生在医学 (URIM) 中的代表人数仍然明显不足. 这种差异影响着服务不足的人群获得医疗保健,凸显了研究生医学教育中需要多样性政策的必要性.
科学领域:
- 医学教育 医学教育
- 健康差异 在健康上的差异
- 医生劳动力的多样性 医生劳动力的多样性
背景情况:
- 来自历史上服务不足的社区的医生在医学中代表性不足 (URIM) 的数量增加对于减少健康差异至关重要.
- 医生-社区协同增强了医疗保健的获取,特别是美国印第安人/阿拉斯加土著,黑人和西班牙裔/拉丁裔人口.
研究的目的:
- 分析美国内部医学 (IM) 居民的县级种族和民族代表性.
- 检查IM居民及其社区之间的一致性.
- 评估代表性如何随着学术机构或服务不足的环境的存在而变化.
主要方法:
- 这是一项回顾性,横截面的研究,利用了美国医学院协会,ACGME,区域卫生资源档案和美国教育部的数据.
- 分析了2018年美国205个县的393个项目中的4,848名IM居民自报的种族和种族数据.
- 计算了代表率 (RQs),并使用定量线性回归模型来评估与县级特征的关联.
主要成果:
- 在医学中代表不足 (URIM) 的居民,包括美洲印第安人/阿拉斯加本土人,黑人和西班牙裔/拉丁裔个人,与其县人口相比,代表性明显不足 (RQs < 1).
- 有IM计划的县中有24.8%没有URIM居民.
- 黑人和西班牙裔/拉丁裔居民在有更多少数民族服务机构 (MSI) 的县占比较高,而西班牙裔/拉丁裔居民在有更多学术卫生中心 (AHC) 的县占比较低. 亚洲居民在有更多MSI的县有较低的RQ,而白人居民在有更多AHC的县有更高的代表性.
结论:
- 在医学中代表不足 (URIM) 内部医学居民相对于其计划的县人口,仍然代表不足.
- 这些发现强调了在医学研究生教育中需要有针对性的种族和民族多样性政策.
- 解决医生代表性不足问题对于改善历史上服务不足的社区的护理至关重要.
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