Growing a rural family physician workforce: The contributions of rural background and rural place of residency training
Growing a rural family physician workforce: The contributions of rural background and rural place of residency training
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DOI：
10.1111/1475-6773.14168
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发表时间：
2023-05-09
影响因子：
3.4
通讯作者：
Longenecker, Randall
中科院分区：
文献类型：
--
作者：
Patterson, Davis G.;Shipman, Scott A.;Longenecker, Randall
目的探讨农村背景和农村住院医师培训对家庭医生农村执业选择的显着影响。数据源和研究设置我们使用了 RTT 合作农村住院医师名单的子集以及来自美国家庭医学委员会全国研究生调查（NGS；三个队列，2016-2018）和美国医学院申请服务（AMCAS）的家庭医生纵向数据。研究设计我们进行了逻辑回归，计算预测边际，以评估背景和住院地点与住院医生 3 年后执业地点的关联。数据收集/提取方法我们将 NGS 数据与居住类型（农村或城市）以及执业地点与农村背景的 AMCAS 数据合并。主要发现 农村背景的家庭医生比城市背景的家庭医生更有可能选择农村诊所（39.2%，95% CI = 35.8，42.5）（13.8%，95% CI = 12.5，15.0）； 50.9%（95% CI = 43.0, 58.8）农村学员选择农村实习，而城市学员选择农村实习的比例为 18.0%（95% CI = 16.8, 19.2）。结论增加农村和城市居民培训项目以及招收更多农村学生接受医学教育，可以增加农村家庭医生的数量。
ObjectiveTo determine the distinct influences of rural background and rural residency training on rural practice choice among family physicians. Data Sources and Study SettingWe used a subset of The RTT Collaborative rural residency list and longitudinal data on family physicians from the American Board of Family Medicine National Graduate Survey (NGS; three cohorts, 2016-2018) and American Medical College Application Service (AMCAS). Study DesignWe conducted a logistic regression, computing predictive marginals to assess associations of background and residency location with physician practice location 3 years post-residency. Data Collection/Extraction MethodsWe merged NGS data with residency type-rural or urban-and practice location with AMCAS data on rural background. Principal FindingsFamily physicians from a rural background were more likely to choose rural practice (39.2%, 95% CI = 35.8, 42.5) than those from an urban background (13.8%, 95% CI = 12.5, 15.0); 50.9% (95% CI = 43.0, 58.8) of trainees in rural residencies chose rural practice, compared with 18.0% (95% CI = 16.8, 19.2) of urban trainees. ConclusionsIncreasing rural programs for training residents from both rural and urban backgrounds, as well as recruiting more rural students to medical education, could increase the number of rural family physicians.