新认证的麻醉学培训项目在卫生专业人员短缺地区和医疗服务不足人群中的地理分布。

James Harvey Jones, Neal Fleming
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引用次数: 0

摘要

背景:扩大服务不足地区的医生队伍是解决医疗差距的当务之急。新住院医师培训项目的设立有助于这些努力。然而,麻醉学培训项目在这方面却鲜有研究。我们的目的是比较新认证的麻醉学培训项目与新的外科、产科和家庭医生项目在卫生专业人员短缺地区(HPSAs)和医疗服务不足人群中的地理分布情况:通过查询美国毕业后医学教育认证委员会(Accreditation Council for Graduate Medical Education)和研究员与住院医师电子交互式数据库访问系统,确定了 2014 年至 2024 年期间获得认证的住院医师培训项目的地点。然后记录培训项目的邮政地址是否与医疗服务不足地区或人群相对应。此外,还收集了HPSA和孕产妇保健目标区(MCTA)的分数,作为每个项目邮寄地址的初级保健或孕产妇保健服务不完善的指标。美国双变量地图定性比较了新认证培训项目的地理分布,方差分析和 t 检验用于比较 HPSA 和 MCTA 分数,χ2 检验用于比较医疗服务不足地区的项目比例:在2014年至2024年期间,48个麻醉学项目获得了认证,同时获得认证的还有127个外科项目、360个家庭医学项目和68个产科项目(总计=603)。HPSA 分数较高的州,其新认证的麻醉学和外科项目数量往往相对较少。麻醉学专业的 HPSA 和 MCTA 平均得分分别与家庭医学专业和产科专业相当(P > .5)。麻醉、外科、家庭医学或产科培训项目在医疗服务不足地区的分布没有明显的统计学差异(P > .5):讨论:新麻醉学和外科培训项目的地理分布在本质上是相似的。与家庭医学和产科培训项目一样,新近获得认证的麻醉学培训项目也位于具有相似需求优先级的 HPSA,这一点可以从统计上相似的 HPSA 和 MCTA 分数中得到证明。然而,在所有新认证的家庭医学、产科、外科和麻醉学培训项目中,只有大约三分之一位于医疗服务不足地区,因此仍需开展大量工作:结论:HPSA 分数较高的州,其新认证的麻醉学和外科项目数量往往相对较少。新获认证的麻醉学培训项目的地点与新获认证的家庭医学和产科培训项目的地点相似,这分别从相似的 HPSA 和 MCTA 分数中可以看出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Geographical Distribution of Newly Accredited Anesthesiology Training Programs in Relation to Health Professional Shortage Areas and Medically Underserved Populations.

Background: Expanding the physician workforce in underserved areas is imperative for addressing healthcare disparities. The creation of new residency training programs has assisted in these efforts. However, anesthesiology training programs are infrequently studied in this regard. Our objective was to compare the geographical distribution of newly accredited anesthesiology training programs with new surgery, obstetrics, and family practice programs with respect to health professional shortage areas (HPSAs) and medically underserved populations.

Methods: The locations of residency training programs accredited between 2014 and 2024 were identified by querying the Accreditation Council for Graduate Medical Education and Fellowship and Residency Electronic Interactive Database Access System. Whether the postal address of the training program corresponded to a medically underserved area or population was then recorded. HPSA and maternal care target area (MCTA) scores were also collected as an indicator of poor access to primary care or maternal care for the postal addresses of each program. Bivariate US maps qualitatively compared the geographical distributions of newly accredited training programs, analysis of variance and t tests were used to compare HPSA and MCTA scores, and χ2 tests were used to compare the percentage of programs in medically underserved areas.

Results: Forty-eight anesthesiology programs became accredited between 2014 and 2024, as well as 127 surgical, 360 family medicine, and 68 obstetrical programs (total = 603). States with higher HPSA scores tended to have a relatively lower numbers of newly accredited anesthesiology and surgery programs. The mean HPSA and MCTA scores for anesthesiology programs were comparable to those for family medicine and obstetrical programs, respectively (P > .5). There was no statistically significant difference noted among the distribution of anesthesia, surgery, family medicine, or obstetrical training programs in medically underserved areas (P > .5).

Discussion: The geographical distributions of new anesthesiology and surgery training programs are qualitatively similar. Like family medicine and obstetrical training programs, newly accredited anesthesiology training programs are in HPSAs with comparable need priorities as evidenced by statistically similar HPSA and MCTA scores. However, with only roughly one-third of all newly accredited family medicine, obstetrical, surgery, and anesthesiology training programs in medically underserved areas, substantial work is still needed.

Conclusion: States with higher HPSA scores tend to have a relatively lower number of newly accredited anesthesiology and surgery programs. The locations of newly accredited anesthesiology training programs are similar to those of newly accredited family medicine and obstetrical training programs as evidenced by similar HPSA and MCTA scores, respectively.

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