Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study
Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training...
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| Veröffentlicht in: | Health policy and planning 2017-07, Vol.32 (6), p.809-815 |
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| description | Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry. A retrospective study was conducted in new medical graduates who entered Ministry of Public Health (MoPH) hospitals from January 2003 to October 2014, and followed up until June 2015, using administrative data from the Personnel Administration Division, MoPH. The CPIRD registry database was used to identify physicians’tracks of entry. Survival analyses and multiple logistic regression analyses were applied to compare the annual retention and the probability of 3-year retention of rural physicians. Results clearly demonstrated a high rural retention of CPIRD medical graduates, compared with their Normal track peers, regarding both lower annual resignation (HR 0.456, P < 0.001) and higher 3-year retention (OR 2.441, CI: 2.192, 2.719). Some variations of rural retention were revealed across the different CPIRD tracks. Evidence from this study can be used as part of the information to reshape the physician production policy to reduce health inequity in rural areas.
农村地区医生短缺是医疗可及性的主要障碍, 导致全球卫生不 公平。泰国实施了专门的医学教育招生制度, 即增加农村医生 合作培养项目（CPIRD）, 设有四个不同的医学培养渠道。此 前没有研究比较过 CPIRD 培养的医学毕业生与正常渠道培养 医学生留用农村地区的状况。本研究调查通过不同渠道入学 的农村医生在公共部门的留用情况。本研究为回顾性研究, 使 用公共卫生部 （MoPH）人员行政处管理数据, 研究对象为 2003 年1 月至 2014 年 10 月进入 MoPH 医院的应届医学毕 业生, 随访至2015 年 6 月。使用 CPIRD 登记数据库确定医 生的招生渠道。采用生存分析和多因素 Logistic 回归分析比 较农村医生的年留用率和 3 年留用率。结果显示 CPIRD 培养 的医学生农村留用情况明显优于正常渠道医学生, 年辞职率较 低 （HR=0.456, P |
| doi_str_mv | 10.1093/heapol/czx026 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_TOX</sourceid><recordid>TN_cdi_proquest_miscellaneous_1881263772</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48509206</jstor_id><oup_id>10.1093/heapol/czx026</oup_id><sourcerecordid>48509206</sourcerecordid><originalsourceid>FETCH-LOGICAL-c448t-ca114964aeb2501b710bb3593ae37aa2ffe312da8cbc5e921933c14503e9ac5b3</originalsourceid><addsrcrecordid>eNqFkUlLBDEQhYMoOi5Hj0rAix5aU0l6yVHGbUBQRM9NOlOtPfR0xiTt9uuNtgt48VTw6uPV8gjZBnYITImjB9QL2x6ZtxfGsyUyApmxhHORL5NRVIoEWMHWyLr3M8ZASpmukjVeCCGVkiPyfNM73VKHAbvQ2I7amnb4TOc4bUxs3Ds97XVAT2tn5zQ8IB3bttWVdTo0T0ivnZ2hCTRYOumMQ-0_tWlvvu2GCSfWBOs83R9fT25ODjbJSq1bj1tfdYPcnZ3eji-Sy6vzyfj4MjFSFiExGkCqTGqseMqgyoFVlUiV0ChyrXldowA-1YWpTIqKgxLCgEyZQKVNWokNsj_4Lpx97NGHct54g_GCDm3vSygK4JnIcx7RvT_ozPaui9uVXApgkClgkUoGyjjrvcO6XLhmrt1rCaz8SKQcEimHRCK_--XaV_GpP_R3BL8b2n7xr9fOgM58_OUPLIuUKc4y8Q5HzKB3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2431016910</pqid></control><display><type>article</type><title>Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study</title><source>Oxford Journals Open Access Collection</source><creator>Techakehakij, Win ; Arora, Rajin</creator><creatorcontrib>Techakehakij, Win ; Arora, Rajin</creatorcontrib><description>Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry. A retrospective study was conducted in new medical graduates who entered Ministry of Public Health (MoPH) hospitals from January 2003 to October 2014, and followed up until June 2015, using administrative data from the Personnel Administration Division, MoPH. The CPIRD registry database was used to identify physicians’tracks of entry. Survival analyses and multiple logistic regression analyses were applied to compare the annual retention and the probability of 3-year retention of rural physicians. Results clearly demonstrated a high rural retention of CPIRD medical graduates, compared with their Normal track peers, regarding both lower annual resignation (HR 0.456, P < 0.001) and higher 3-year retention (OR 2.441, CI: 2.192, 2.719). Some variations of rural retention were revealed across the different CPIRD tracks. Evidence from this study can be used as part of the information to reshape the physician production policy to reduce health inequity in rural areas.
农村地区医生短缺是医疗可及性的主要障碍, 导致全球卫生不 公平。泰国实施了专门的医学教育招生制度, 即增加农村医生 合作培养项目（CPIRD）, 设有四个不同的医学培养渠道。此 前没有研究比较过 CPIRD 培养的医学毕业生与正常渠道培养 医学生留用农村地区的状况。本研究调查通过不同渠道入学 的农村医生在公共部门的留用情况。本研究为回顾性研究, 使 用公共卫生部 （MoPH）人员行政处管理数据, 研究对象为 2003 年1 月至 2014 年 10 月进入 MoPH 医院的应届医学毕 业生, 随访至2015 年 6 月。使用 CPIRD 登记数据库确定医 生的招生渠道。采用生存分析和多因素 Logistic 回归分析比 较农村医生的年留用率和 3 年留用率。结果显示 CPIRD 培养 的医学生农村留用情况明显优于正常渠道医学生, 年辞职率较 低 （HR=0.456, P<0.001）, 3年留用率较高（OR=2.441, CI： 2.192, 2.719） 。 不同 CPIRD 渠道的农村留用率有所差 异。本研究得出的证据有助于指导重塑医生培养政策, 从而改 善农村地区卫生公平性。
La escasez de médicos en áreas rurales es un obstáculo importante para el acceso a la asistencia médica, lo que genera inequidad de la salud en todo el mundo. En Tailandia, se inició un programa especial de reclutamiento de educación médica [Proyecto Colaborativo para Aumentar la Producción de Médicos Rurales (PCAMR)] con cuatro vías de entrenamiento médico. Ninguna investigación anterior ha examinado la retención rural de nuevos graduados médicos a través de las vías del PCAMR, comparados con los que reciben educación médica convencional (vía normal). Este estudio examina la retención pública de médicos rurales de diferentes vías de entrada. Se realizó un estudio retrospectivo de los nuevos médicos graduados que ingresaron a los hospitales del Ministerio de Salud Pública (MoSP) desde enero de 2003 hasta octubre de 2014 y se les hizo seguimiento hasta junio de 2015, usando los datos administrativos de la División de Administración de Personal, MoSP. La base de datos de registro del PCAMR se usó para identificar las vías de entrada de los médicos. Se aplicaron análisis de supervivencia y análisis de regresión logística múltiple para comparar la retención anual y la probabilidad de retención de tres años de médicos rurales. Los resultados demostraron claramente una alta retención rural de los médicos graduados del PCAMR, en comparación con sus pares de la vía normal, con respecto a renuncia anual más baja (TR 0.456, P<0.001) y a una retención más alta de 3 años (RP 2.441, IC: 2.192, 2.719). Algunas variaciones de retención rural fueron reveladas a través de las diversas vías del PCAMR. La evidencia de este estudio puede ser usada como parte de la información para remodelar la política de producción del médico para reducir la inequidad en salud en las áreas rurales.</description><identifier>ISSN: 0268-1080</identifier><identifier>EISSN: 1460-2237</identifier><identifier>DOI: 10.1093/heapol/czx026</identifier><identifier>PMID: 28334994</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Collaboration ; Education ; Education, Medical - organization & administration ; Education, Medical - statistics & numerical data ; Female ; Health administration ; Health care access ; Health disparities ; Hospitals ; Hospitals, Public - manpower ; Hospitals, Rural - manpower ; Humans ; Male ; Medical education ; Medical personnel ; Medical research ; ORIGINAL ARTICLES ; Peers ; Physicians ; Physicians - statistics & numerical data ; Production ; Public health ; Recruitment ; Regression analysis ; Retention ; Retrospective Studies ; Rural areas ; Rural communities ; Scarcity ; Statistical analysis ; Thailand</subject><ispartof>Health policy and planning, 2017-07, Vol.32 (6), p.809-815</ispartof><rights>The Author 2017</rights><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017</rights><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-ca114964aeb2501b710bb3593ae37aa2ffe312da8cbc5e921933c14503e9ac5b3</citedby><cites>FETCH-LOGICAL-c448t-ca114964aeb2501b710bb3593ae37aa2ffe312da8cbc5e921933c14503e9ac5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48509206$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48509206$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,777,781,800,1599,27847,27905,27906,30980,57998,58231</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/heapol/czx026$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28334994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Techakehakij, Win</creatorcontrib><creatorcontrib>Arora, Rajin</creatorcontrib><title>Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study</title><title>Health policy and planning</title><addtitle>Health Policy Plan</addtitle><description>Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry. A retrospective study was conducted in new medical graduates who entered Ministry of Public Health (MoPH) hospitals from January 2003 to October 2014, and followed up until June 2015, using administrative data from the Personnel Administration Division, MoPH. The CPIRD registry database was used to identify physicians’tracks of entry. Survival analyses and multiple logistic regression analyses were applied to compare the annual retention and the probability of 3-year retention of rural physicians. Results clearly demonstrated a high rural retention of CPIRD medical graduates, compared with their Normal track peers, regarding both lower annual resignation (HR 0.456, P < 0.001) and higher 3-year retention (OR 2.441, CI: 2.192, 2.719). Some variations of rural retention were revealed across the different CPIRD tracks. Evidence from this study can be used as part of the information to reshape the physician production policy to reduce health inequity in rural areas.
农村地区医生短缺是医疗可及性的主要障碍, 导致全球卫生不 公平。泰国实施了专门的医学教育招生制度, 即增加农村医生 合作培养项目（CPIRD）, 设有四个不同的医学培养渠道。此 前没有研究比较过 CPIRD 培养的医学毕业生与正常渠道培养 医学生留用农村地区的状况。本研究调查通过不同渠道入学 的农村医生在公共部门的留用情况。本研究为回顾性研究, 使 用公共卫生部 （MoPH）人员行政处管理数据, 研究对象为 2003 年1 月至 2014 年 10 月进入 MoPH 医院的应届医学毕 业生, 随访至2015 年 6 月。使用 CPIRD 登记数据库确定医 生的招生渠道。采用生存分析和多因素 Logistic 回归分析比 较农村医生的年留用率和 3 年留用率。结果显示 CPIRD 培养 的医学生农村留用情况明显优于正常渠道医学生, 年辞职率较 低 （HR=0.456, P<0.001）, 3年留用率较高（OR=2.441, CI： 2.192, 2.719） 。 不同 CPIRD 渠道的农村留用率有所差 异。本研究得出的证据有助于指导重塑医生培养政策, 从而改 善农村地区卫生公平性。
La escasez de médicos en áreas rurales es un obstáculo importante para el acceso a la asistencia médica, lo que genera inequidad de la salud en todo el mundo. En Tailandia, se inició un programa especial de reclutamiento de educación médica [Proyecto Colaborativo para Aumentar la Producción de Médicos Rurales (PCAMR)] con cuatro vías de entrenamiento médico. Ninguna investigación anterior ha examinado la retención rural de nuevos graduados médicos a través de las vías del PCAMR, comparados con los que reciben educación médica convencional (vía normal). Este estudio examina la retención pública de médicos rurales de diferentes vías de entrada. Se realizó un estudio retrospectivo de los nuevos médicos graduados que ingresaron a los hospitales del Ministerio de Salud Pública (MoSP) desde enero de 2003 hasta octubre de 2014 y se les hizo seguimiento hasta junio de 2015, usando los datos administrativos de la División de Administración de Personal, MoSP. La base de datos de registro del PCAMR se usó para identificar las vías de entrada de los médicos. Se aplicaron análisis de supervivencia y análisis de regresión logística múltiple para comparar la retención anual y la probabilidad de retención de tres años de médicos rurales. Los resultados demostraron claramente una alta retención rural de los médicos graduados del PCAMR, en comparación con sus pares de la vía normal, con respecto a renuncia anual más baja (TR 0.456, P<0.001) y a una retención más alta de 3 años (RP 2.441, IC: 2.192, 2.719). Algunas variaciones de retención rural fueron reveladas a través de las diversas vías del PCAMR. La evidencia de este estudio puede ser usada como parte de la información para remodelar la política de producción del médico para reducir la inequidad en salud en las áreas rurales.</description><subject>Collaboration</subject><subject>Education</subject><subject>Education, Medical - organization & administration</subject><subject>Education, Medical - statistics & numerical data</subject><subject>Female</subject><subject>Health administration</subject><subject>Health care access</subject><subject>Health disparities</subject><subject>Hospitals</subject><subject>Hospitals, Public - manpower</subject><subject>Hospitals, Rural - manpower</subject><subject>Humans</subject><subject>Male</subject><subject>Medical education</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>ORIGINAL ARTICLES</subject><subject>Peers</subject><subject>Physicians</subject><subject>Physicians - statistics & numerical data</subject><subject>Production</subject><subject>Public health</subject><subject>Recruitment</subject><subject>Regression analysis</subject><subject>Retention</subject><subject>Retrospective Studies</subject><subject>Rural areas</subject><subject>Rural communities</subject><subject>Scarcity</subject><subject>Statistical analysis</subject><subject>Thailand</subject><issn>0268-1080</issn><issn>1460-2237</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqFkUlLBDEQhYMoOi5Hj0rAix5aU0l6yVHGbUBQRM9NOlOtPfR0xiTt9uuNtgt48VTw6uPV8gjZBnYITImjB9QL2x6ZtxfGsyUyApmxhHORL5NRVIoEWMHWyLr3M8ZASpmukjVeCCGVkiPyfNM73VKHAbvQ2I7amnb4TOc4bUxs3Ds97XVAT2tn5zQ8IB3bttWVdTo0T0ivnZ2hCTRYOumMQ-0_tWlvvu2GCSfWBOs83R9fT25ODjbJSq1bj1tfdYPcnZ3eji-Sy6vzyfj4MjFSFiExGkCqTGqseMqgyoFVlUiV0ChyrXldowA-1YWpTIqKgxLCgEyZQKVNWokNsj_4Lpx97NGHct54g_GCDm3vSygK4JnIcx7RvT_ozPaui9uVXApgkClgkUoGyjjrvcO6XLhmrt1rCaz8SKQcEimHRCK_--XaV_GpP_R3BL8b2n7xr9fOgM58_OUPLIuUKc4y8Q5HzKB3</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Techakehakij, Win</creator><creator>Arora, Rajin</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>8BJ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD)</title><author>Techakehakij, Win ; Arora, Rajin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-ca114964aeb2501b710bb3593ae37aa2ffe312da8cbc5e921933c14503e9ac5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Collaboration</topic><topic>Education</topic><topic>Education, Medical - organization & administration</topic><topic>Education, Medical - statistics & numerical data</topic><topic>Female</topic><topic>Health administration</topic><topic>Health care access</topic><topic>Health disparities</topic><topic>Hospitals</topic><topic>Hospitals, Public - manpower</topic><topic>Hospitals, Rural - manpower</topic><topic>Humans</topic><topic>Male</topic><topic>Medical education</topic><topic>Medical personnel</topic><topic>Medical research</topic><topic>ORIGINAL ARTICLES</topic><topic>Peers</topic><topic>Physicians</topic><topic>Physicians - statistics & numerical data</topic><topic>Production</topic><topic>Public health</topic><topic>Recruitment</topic><topic>Regression analysis</topic><topic>Retention</topic><topic>Retrospective Studies</topic><topic>Rural areas</topic><topic>Rural communities</topic><topic>Scarcity</topic><topic>Statistical analysis</topic><topic>Thailand</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Techakehakij, Win</creatorcontrib><creatorcontrib>Arora, Rajin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Health policy and planning</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Techakehakij, Win</au><au>Arora, Rajin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study</atitle><jtitle>Health policy and planning</jtitle><addtitle>Health Policy Plan</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>32</volume><issue>6</issue><spage>809</spage><epage>815</epage><pages>809-815</pages><issn>0268-1080</issn><eissn>1460-2237</eissn><abstract>Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry. A retrospective study was conducted in new medical graduates who entered Ministry of Public Health (MoPH) hospitals from January 2003 to October 2014, and followed up until June 2015, using administrative data from the Personnel Administration Division, MoPH. The CPIRD registry database was used to identify physicians’tracks of entry. Survival analyses and multiple logistic regression analyses were applied to compare the annual retention and the probability of 3-year retention of rural physicians. Results clearly demonstrated a high rural retention of CPIRD medical graduates, compared with their Normal track peers, regarding both lower annual resignation (HR 0.456, P < 0.001) and higher 3-year retention (OR 2.441, CI: 2.192, 2.719). Some variations of rural retention were revealed across the different CPIRD tracks. Evidence from this study can be used as part of the information to reshape the physician production policy to reduce health inequity in rural areas.
农村地区医生短缺是医疗可及性的主要障碍, 导致全球卫生不 公平。泰国实施了专门的医学教育招生制度, 即增加农村医生 合作培养项目（CPIRD）, 设有四个不同的医学培养渠道。此 前没有研究比较过 CPIRD 培养的医学毕业生与正常渠道培养 医学生留用农村地区的状况。本研究调查通过不同渠道入学 的农村医生在公共部门的留用情况。本研究为回顾性研究, 使 用公共卫生部 （MoPH）人员行政处管理数据, 研究对象为 2003 年1 月至 2014 年 10 月进入 MoPH 医院的应届医学毕 业生, 随访至2015 年 6 月。使用 CPIRD 登记数据库确定医 生的招生渠道。采用生存分析和多因素 Logistic 回归分析比 较农村医生的年留用率和 3 年留用率。结果显示 CPIRD 培养 的医学生农村留用情况明显优于正常渠道医学生, 年辞职率较 低 （HR=0.456, P<0.001）, 3年留用率较高（OR=2.441, CI： 2.192, 2.719） 。 不同 CPIRD 渠道的农村留用率有所差 异。本研究得出的证据有助于指导重塑医生培养政策, 从而改 善农村地区卫生公平性。
La escasez de médicos en áreas rurales es un obstáculo importante para el acceso a la asistencia médica, lo que genera inequidad de la salud en todo el mundo. En Tailandia, se inició un programa especial de reclutamiento de educación médica [Proyecto Colaborativo para Aumentar la Producción de Médicos Rurales (PCAMR)] con cuatro vías de entrenamiento médico. Ninguna investigación anterior ha examinado la retención rural de nuevos graduados médicos a través de las vías del PCAMR, comparados con los que reciben educación médica convencional (vía normal). Este estudio examina la retención pública de médicos rurales de diferentes vías de entrada. Se realizó un estudio retrospectivo de los nuevos médicos graduados que ingresaron a los hospitales del Ministerio de Salud Pública (MoSP) desde enero de 2003 hasta octubre de 2014 y se les hizo seguimiento hasta junio de 2015, usando los datos administrativos de la División de Administración de Personal, MoSP. La base de datos de registro del PCAMR se usó para identificar las vías de entrada de los médicos. Se aplicaron análisis de supervivencia y análisis de regresión logística múltiple para comparar la retención anual y la probabilidad de retención de tres años de médicos rurales. Los resultados demostraron claramente una alta retención rural de los médicos graduados del PCAMR, en comparación con sus pares de la vía normal, con respecto a renuncia anual más baja (TR 0.456, P<0.001) y a una retención más alta de 3 años (RP 2.441, IC: 2.192, 2.719). Algunas variaciones de retención rural fueron reveladas a través de las diversas vías del PCAMR. La evidencia de este estudio puede ser usada como parte de la información para remodelar la política de producción del médico para reducir la inequidad en salud en las áreas rurales.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>28334994</pmid><doi>10.1093/heapol/czx026</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext_linktorsrc |
| identifier | ISSN: 0268-1080 |
| ispartof | Health policy and planning, 2017-07, Vol.32 (6), p.809-815 |
| issn | 0268-1080 1460-2237 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1881263772 |
| source | Oxford Journals Open Access Collection |
| subjects | Collaboration Education Education, Medical - organization & administration Education, Medical - statistics & numerical data Female Health administration Health care access Health disparities Hospitals Hospitals, Public - manpower Hospitals, Rural - manpower Humans Male Medical education Medical personnel Medical research ORIGINAL ARTICLES Peers Physicians Physicians - statistics & numerical data Production Public health Recruitment Regression analysis Retention Retrospective Studies Rural areas Rural communities Scarcity Statistical analysis Thailand |
| title | Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study |
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