The wineglass model: tracking the locational histories of health professionals.
The wineglass model: tracking the locational histories of health professionals.
复制标题
酒杯模型：跟踪卫生专业人员的位置历史。
DOI：
10.1016/s0277-9536(99)00293-2
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Konrad,TR
中科院分区：
文献类型：
--
作者：
Baer,LD;Gesler,WM;Konrad,TR
本文介绍了一个时空连续体模型来评估项目的有效性，鼓励招聘和留住卫生专业人员。基于酒杯的形状，该模型提供了一个框架来研究一个队列的卫生专业人员的位置的历史，概念和定量。该模型的一个关键组成部分是，它测量随着时间的推移从医学院，住院医生计划，或其他共享位置的地理分散。在模型中可以通过标准偏差椭圆、标准距离或平均距离圆来研究地理分散。该模型通过结构化理论进行分析，该理论被用作分析人类机构（例如，关于实践地点的个人决定）和结构（例如，医学教育）。时空建模与结构化理论联系在一起。酒杯形状的变化揭示了人们可能如何被一个总体结构所束缚，然而，通过一生的位置决定可能会随着空间和时间的推移而改变这种结构。利用内布拉斯加大学校友的数据，作者构建了一个试点示范，以测试和确认该模型的潜在有用性。在试点演示中，标准偏差椭圆表示每年医生位置的范围，覆盖在美国地图上。试点示范表明，该模型在确定随着时间的推移不断变化的流动性方面具有优势，同时也指出了人们对数据可用性从一年到下一年不均衡的关切。酒杯模型的进一步应用可以用于研究健康专业人员的生活史。基于社区的培训对长期或短期保留的影响，男性与女性提供者流动性的变化，以及不同卫生专业或医学院人员的职业轨迹，只是该模型未来潜在应用的几个例子。
This paper introduces a space–time continuum model to evaluate the effectiveness of programs that encourage recruitment and retention of health professionals. Based on the shape of a wineglass, the model provides a framework to study the locational histories of a cohort of health professionals, both conceptually and quantitatively. A key component of the model is that it measures geographic dispersion over time from a medical school, residency program, or other shared location. Geographic dispersion can be studied in the model through standard deviational ellipses, standard distance, or average distance circles. The model enables analysis through structuration theory, which is used as a guide for analyzing the interplay between human agency (e.g., individual decisions on practice location) and structure (e.g., medical education). Space–time modeling is linked with structuration theory. Variations in the shape of the wineglass reveal how people may be bound by a general structure, yet through lifetime locational decisions may change that structure over space and time. Using data on University of Nebraska alumni, the authors constructed a pilot demonstration to test and confirm the model’s potential usefulness. In the pilot demonstration, standard deviational ellipses represented the range of physician locations during each year, overlaid on maps of the US. The pilot demonstration indicated the model’s strength in identifying changing mobility over time, while also pointing to concerns about unevenness in data availability from one year to the next. Further application of the wineglass model could be used toward studying the life histories of health professionals. The impact of community-based training on long- or short-term retention, changes in the mobility of male vs female providers, and the career trajectories of people in different health professions or medical schools are only a few examples of potential future applications of the model.