Mobility of US Rural Primary Care Physicians During 2000–2014
| العنوان: | Mobility of US Rural Primary Care Physicians During 2000–2014 |
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| المؤلفون: | Andrew Bazemore, Matthew Richard McGrail, Peter Wingrove, Stephen Petterson |
| المصدر: | The Annals of Family Medicine. 15:322-328 |
| بيانات النشر: | Annals of Family Medicine, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, Geographic mobility, Personnel Turnover, Physicians, Primary Care, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Rurality, Humans, Medicine, 030212 general & internal medicine, Sex Distribution, Original Research, business.industry, 030503 health policy & services, Rural health, Primary care physician, Odds ratio, Middle Aged, Metropolitan area, Physician supply, United States, Career Mobility, Workforce, Linear Models, Female, Rural Health Services, 0305 other medical science, Family Practice, business, Demography |
| الوصف: | PURPOSE Despite considerable investment in increasing the number of primary care physicians in rural shortage areas, little is known about their movement rates and factors influencing their mobility. We aimed to characterize geographic mobility among rural primary care physicians, and to identify location and individual factors that influence such mobility. METHODS Using data from the American Medical Association Physician Masterfile for each clinically active US physician, we created seven 2-year (biennial) mobility periods during 2000–2014. These periods were merged with county-level “rurality,” physician supply, economic characteristics, key demographic measures, and individual physician characteristics. We computed (1) mobility rates of physicians by rurality; (2) linear regression models of county-level rural nonretention (departure); and (3) logit models of physicians leaving rural practice. RESULTS Biennial turnover was about 17% among physicians aged 45 and younger, compared with 9% among physicians aged 46 to 65, with little difference between rural and metropolitan groups. County-level physician mobility was higher for counties that lacked a hospital (absolute increase = 5.7%), had a smaller population size, and had lower primary care physician supply, but area-level economic and demographic factors had little impact. Female physicians (odds ratios = 1.24 and 1.46 for those aged 45 or younger and those aged 46 to 65, respectively) and physicians born in a metropolitan area (odds ratios = 1.75 and 1.56 for those aged 45 or younger and those aged 46 to 65, respectively) were more likely to leave rural practice. CONCLUSIONS These flndings provide national-level evidence of rural physician mobility rates and factors associated with both county-level retention and individual-level departures. Outcomes were notably poorer in the most remote locations and those already having poorer physician supply and professional support. Rural health workforce planners and policymakers must be cognizant of these key factors to more effectively target retention policies and to take into account the additional support needed by these more vulnerable communities. |
| تدمد: | 1544-1717 1544-1709 |
| DOI: | 10.1370/afm.2096 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c70d6afa95fd25a8b22fa0a95e150678 https://doi.org/10.1370/afm.2096 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c70d6afa95fd25a8b22fa0a95e150678 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15441717 15441709 |
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| DOI: | 10.1370/afm.2096 |