作者: David C. Goodman
DOI: 10.1001/JAMA.1996.03540220035027
关键词: Gerontology 、 Population 、 Physician supply 、 Managed care 、 Referral 、 Per capita 、 Family medicine 、 Specialty 、 Medicine 、 Health care 、 Workforce
摘要: Objective. —To propose population-based benchmarking as an alternative to needs- or demand-based planning for estimating a reasonably sized, clinically active physician workforce the United States and its regional health care markets. Design. —Cross-sectional analysis of 1993 American Medical Association Osteopathic masterfiles. Population. —The resident population 306 hospital referral regions in States. Main Outcome Measures. —Per capita number physicians by specialty adjusted age sex differences out-of-region utilization. The measured was compared with 4 benchmarks: staffing within large (2.4 million members) maintenance organization (HMO), region dominated managed (Minneapolis, Minn), fee-for-service (Wichita, Kan), proposed "balanced" supply (50% generalists). Results. proportion US residing higher per generalist than benchmark 96% HMO benchmark, 60% Wichita, 27% Minneapolis. specialist exceeded all 3 benchmarks 74% population. generalists not related among (Pearson correlation coefficient=0.06; P =.26). Conclusions. —Population-based offers practical advantages sized physicians. markets indicates varying opportunities employment services. ratio specialists does measure adequacy either nationally specific regions. Research measuring relationship between workforces different sizes outcomes will guide selection future benchmarks.