Managed care reduces the demand for internal medicine subspecialists, but little empirical information is available on how increasing managed care may be affecting residents'training choices.
To determine whether increased managed care penetration into an area where residents train was associated with a decreased likelihood that residents who completed general internal medicine training pursued subspecialty training.
Secondary logistic regression analysis of data from the 1993 cohort of general internal medicine residents.
U.S. residency training sites.
2263 U.S. medical school graduates who completed general internal medicine residency training in 1993.
The outcome variable (enrollment in subspecialty training) was derived from the Graduate Medical Education Tracking Census of the Association of American Medical Colleges (AAMC).
Health maintenance organization (HMO) penetration (possible range, 0.0 to 1.0 ; higher values indicate greater penetration) was taken from the Interstudy Competitive Edge Database.
Individual and medical school covariates were taken from the AAMC's Student and Applicant Information Management System database and the National Institutes of Health Information for Management Planning, Analysis, and Coordination system.
The U.S. Census division was included as a control covariate.
980 participants (43%) enrolled in subspecialty training. (...)
Mots-clés Pascal : Médecine générale, Spécialité médicale, Information marché, Etats Unis, Amérique du Nord, Amérique, Soin intégré, Enseignement, Homme
Mots-clés Pascal anglais : Internal medicine, Medical specialty, Market information, United States, North America, America, Managed care, Teaching, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0286130
Code Inist : 002B30A09. Création : 27/11/1998.