更多的医生供应与农村县的较低死亡率有关:一个为期23年的县级纵向观察性研究
Nasim B Ferdows1,2, Cyrus Kosar3,4, Orestis Panagiotou3,4
1Department of Public Health and Health Sciences, Northeastern University, Boston, MA, USA.
概括
增加农村地区的初级保健医生可以显著降低死亡率. 这项研究强调,迫切需要解决农村医生短缺问题,改善医疗保健准入,以减少健康差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
- 公共卫生政策 公共卫生政策
背景情况:
- 与城市同行相比,美国农村居民的死亡率更高,获得初级保健医生的机会有限.
- 关于医生供应和健康结果的现有研究显示出混合的结果,很少有研究解决了农村和城市死亡率差异.
- 农村地区,尽管有更多的医院床位,但医生供应比城市地区低,增长较慢.
研究的目的:
- 量化额外的初级保健医生供应在美国农村和城市县的边际好处.
- 检查医生供应对死亡率的影响,独立于其他医疗保健和社会经济因素.
- 评估增加医生供应在减少农村和城市死亡率差异方面的潜力.
主要方法:
- 一项为期23年的县级纵向观测研究 (1992-2014) 涵盖了美国2942个县.
- 利用CDC WONDER的死亡率数据,区域卫生资源文件用于医生供应和社会经济数据,以及USDA农村城市连续代码用于农村地区的分类.
- 雇佣回归分析以估计年龄调整后死亡率和医生供应之间的关联,控制县级特征.
主要成果:
- 在县级的医生供应和死亡率之间发现了负相关性.
- 在农村县,增加的医生供应与较低的死亡率相关. 每10万人口增加1名医生与邻近农村县死亡人数减少1.4人,与非邻近农村县死亡人数减少0.936人有关.
- 在城市地区,每10万人口中有0.038例死亡人数减少,而在城市地区,每10万人口中有0.038例死亡人数减少,而在城市地区,每10万人口中有0.038例死亡人数减少.
结论:
- 已经服务不足的农村地区医生供应的减少是一个关键的公共卫生问题.
- 旨在扩大农村卫生网络和增加医疗人员的政策干预措施对于缓解死亡率差异至关重要.
- 这些发现强调了农村医生短缺和美国日益扩大的死亡率差距的持续相关性.
相关概念视频
02:20Longitudinal Research
13.0K
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
13.0K
01:26Methods Of Healthcare Delivery System
3.9K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.9K
01:29Issues And Trends In Healthcare Delivery System
6.1K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
6.1K
01:29Bias in Epidemiological Studies
1.2K
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
1.2K
01:29Documentation in Long-Term and Home Healthcare Setting
1.4K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.4K
01:30Primary Healthcare Services
1.9K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.9K