Abstract
ObjectivesTo evaluate the effect of monetary grants on young physicians’ choice of remote or rural hospital-based practice.BackgroundIn late 2011, The Israeli Ministry of Health attempted to address a severe physician maldistribution, which involved severe shortages in remotely-located institutions (RLI). The policy intervention included offering monetary grants to residents who chose a residency program in a RLI.MethodsA total of 222 residents from various disciplines were recruited; 114 residents from RLI and 108 residents from central-located institutions (CLI), who began their residency during 2012–2014. Participants were surveyed on demographic, academic and professional data, and on considerations in the choice of residency location.ResultsResidents in RLI attributed significantly more importance to the grant in their decision-making process than did residents from CLI. This effect remained significant in a multivariate model (OR 1.65, 95% CI 1.20–2.27, p = 0.002). The only parameter significantly associated with attributing importance to the grant was older age (OR 1.09, 95% CI 1.00–1.19, p = 0.049).ConclusionThe choice of a RLI for residency may be influenced by monetary grants. This is consistent with real-life data showing an increase in medical staffing in these areas during the program’s duration. Further studies are needed to determine causality and physical practicality of such programs.
Highlights
In late 2011, The Israeli Ministry of Health attempted to address a severe physician maldistribution, which involved severe shortages in remotely-located institutions (RLI)
The choice of a RLI for residency may be influenced by monetary grants
For the purpose of this study, we defined the participating medical centers using a dichotomous definition of central- and remotely-located institutions (CLI and RLI, respectively)
Summary
In late 2011, The Israeli Ministry of Health attempted to address a severe physician maldistribution, which involved severe shortages in remotely-located institutions (RLI). Reducing gaps in the quality and availability of medical services between urban and rural areas, as well as central and remote communities, remains a prime challenge for public health system leaders worldwide. This is an issue of concern to healthcare administrators and regulators, and it affects human rights and social equality. Existing models to steer physicians to remote or rural regions It has been shown that deficits in medical manpower affect remote regions first and more strongly than central areas [1]. Adding more physicians to the system is a costly intervention that requires a robust infrastructure of academic clinical resources and training facilities, takes many years to begin influencing actual medical staffing and may not be effective in steering physicians to remote regions [2]
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