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  1. Market influences on internal medicine residents'decisions to subspecialize.

    Article - En anglais

    Background 

    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.

    Objective 

    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.

    Design 

    Secondary logistic regression analysis of data from the 1993 cohort of general internal medicine residents.

    Setting 

    U.S. residency training sites.

    Participants 

    2263 U.S. medical school graduates who completed general internal medicine residency training in 1993.

    Measurements 

    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.

    Results 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0286130

    Code Inist : 002B30A09. Création : 27/11/1998.