进入初级保健的途径:从医学院毕业到专业培训的轨迹绘制图
William R Phillips1, Jeongyoung Park2, Michael Topmiller3
1William R. Phillips (wphllps@uw.edu), University of Washington, Seattle, Washington.
医生培训途径显示,虽然家庭医学具有较高的初级保健收益率,但许多医生离开内部医学和儿科以获得子专业. 了解这些轨迹对于解决医生短缺至关重要.
科学领域:
- 卫生政策 卫生政策
- 医学教育 医学教育
- 医生劳动力研究 医生劳动力研究
背景情况:
- 美国医疗保健面临着初级保健医生短缺的问题,影响了医疗保健的准入,质量和公平.
- 关于医生培训途径的错误信息使政策解决方案复杂化.
研究的目的:
- 分析从医学院到初级保健专业的研究生培训的医生培训轨迹.
- 量化不同专业和医生类型的初级保健产量.
主要方法:
- 使用美国医学会医生主档和历史住院档案数据进行回顾性队列研究.
- 对医学博士,骨科医学博士和国际医学毕业生 (2001-2015) 的医生培训途径的分析.
- 桑基图用于可视化培训计划流动.
主要成果:
- 在2001-2015年毕业的353590名医生中,初步培训包括11.8%的家庭医学,33.5%的内科医学和10.5%的儿科医学.
- 家庭医学的初级保健收益率为97.0%,内部医学为35.5%,儿科为54.4%.
- 很大比例的医生在内部医学和儿科住院后离开初级保健,接受子专业培训.
结论:
- 家庭医疗证明了在初级保健医院住院后的保留率很高.
- 内部医学和儿科看到从初级保健到子专业的大量消耗.
- 需要进一步的研究来追踪进入初级保健实践职业的医生.
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