研究生医学教育改革. 服务提供过渡成本 服务提供过渡成本
J J Stoddard1, D A Kindig, D Libby
1Department of Pediatrics, University of Wisconsin-Madison Medical School 53706-1532.
JAMA
|July 6, 1994
概括
研究生医学教育改革可能会带来长期的大幅节省,但会产生初始成本. 预计,家庭工作人员的替换每年将使教学医院花费14亿至18亿美元.
科学领域:
- 卫生经济学 卫生经济学
- 医学教育政策 医学教育政策
- 医疗保健工作人员分析
背景情况:
- 目前的研究生医学教育 (GME) 系统面临着对其成本效益和效率的审查.
- 目前正在考虑对GME进行改革,以优化教学医院内的培训和资源配置.
- 了解取代家庭工作人员的财务影响对于成功的GME改革至关重要.
研究的目的:
- 分析在改革后的GME系统中取代房子工作人员 (居民和研究员) 的潜在策略.
- 估计美国教学医院这些替代策略的相关成本.
- 为考虑GME改革的政策制定者和医院管理人员提供经济见解.
主要方法:
- 开发了一个经济模型来模拟两种不同的家庭工作人员替代情况.
- 场景1:一个低成本的模型,涉及非医生提供者,工作人员医生,护士和辅助人员.
- 场景2:一个成本更高的传统模式,更多地依赖于工作人员医生.
- 该模型预测了每名全职同等值 (FTE) 家庭官员的净替代成本和总的国家成本估计.
主要成果:
- 净年替代成本估计在低成本模型中为每FTE58,000美元,在高成本模型中为每FTE77,000美元.
- 据估计,将有23,200个家庭工作人员职位被淘汰,预计全国总替代成本每年将在14亿至18亿美元之间.
- 这些数字代表了教学医院在过渡期所承受的净成本.
结论:
- 研究生医学教育改革为长期大幅节省成本提供了机会.
- 然而,服务供应的转型需要在短期内增加新的支出.
- 战略规划对于管理GME改革和房屋工作人员更换的财务影响至关重要.
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