家庭医生实践范围的区域差异
Alyssa Lambert1, Sarah E Fleischer1, Omer Atac1
1From the CHRISTUS Health/Texas A&M University School of Medicine - Family Medicine Residency, Corpus Christi, TX (AL); American Board of Family Medicine, Lexington, KY (SEF, AB, LEP); Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY (OA); Public Health, International School of Medicine, Istanbul Medipol University, Istanbul, Turkiye (OA); Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY (LEP).
尽管考虑到临床医生和实践因素,家庭医生实践范围的地理差异仍然存在. 了解这些差异需要探索针对性干预的多因素原因.
科学领域:
- 医学实践的变化 医学实践的变化
- 医疗保健服务研究 医疗服务研究
- 医生劳动力研究 医生劳动力研究
背景情况:
- 已知医生实践范围 (SOP) 的地理差异,但其潜在原因尚不清楚.
- 调查影响不同地区家庭医生 (FP) SOP变化的因素对于了解医疗保健提供至关重要.
- 这项研究探讨了FP SOP地理差异的未知原因.
研究的目的:
- 确定临床医生,实践,实践环境或医疗保健市场特征的差异是否解释了家庭医生SOP的地理差异.
- 分析各种因素对早期和中期到晚期职业生涯家庭医生的实践范围的影响.
- 确定医疗保健提供者自主权区域差异的潜在驱动因素.
主要方法:
- 利用美国家庭医学委员会 (ABFM) 数据集 (2017-2022),包括早期和中期到晚期职业生涯的FP.
- 雇员的实践范围 (SOP) 得分 (0-30),较高的得分表明更广泛的实践权威.
- 进行了双变量和多级线性回归分析,以评估人口普查划分的地理差异,并根据多个特征进行调整.
主要成果:
- 包括9378名职业生涯早期和28832名职业生涯中后期的FP.
- 在临床医生特征,SOP分数和职业生涯阶段的显著差异被观察到跨部门.
- 调整临床医生,实践,社区和医疗保健市场因素并没有减少SOP中观察到的地理差异.
结论:
- 家庭医生SOP的地理差异并不能由分析的临床医生,实践,社区或市场特征来解释.
- 持续存在的区域差异表明,医疗保健的变化是多因素的.
- 解决这些差异需要全面的,多方面的干预措施.
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