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住院医师培训补贴与医师短缺

Medical residency subsidies and physician shortages
Journal of Public Economics · 2025 · Cici McNamara、Mayra Pineda-Torres

中文摘要

我们通过考察《平价医疗法案》第5503条的影响,量化联邦研究生医学教育补贴对初级保健医师(PCP)供给的影响。该条款增加了农村和高需求地区教学医院可获得培训补贴的住院医师名额。利用该项目的资格标准作为选择进入项目的工具变量,我们发现该条款既增加了高需求地区初级保健项目对住院医师的招募,也增加了住院医师在当地教学医院的工作时间,从而使初级保健医师供给增加4.1%。• 《平价医疗法案》第5503条将住院医师培训补贴重新分配至高需求地区。• 我们使用工具变量处理医院选择进入第5503条项目的问题。• 高需求地区初级保健项目的住院医师招募有所增加。• 高需求地区的初级保健医师供给增加4%。

Abstract

We quantify the impact of federal subsidies for graduate medical education on primary care physician (PCP) supply by examining the impact of Section 5503 of the Affordable Care Act, which increased the number of residents that teaching hospitals in rural and high-need areas could receive subsidies for training. Instrumenting for selection into the program using its eligibility criteria, we find that the provision increased both recruitment of residents into primary care and time spent at teaching hospitals in high-need areas, resulting in a 4.1 % increase in PCP supply. • Section 5503 of the ACA reallocated residency subsidies to high-need areas. • We address hospitals’ selection into Section 5503 using instrumental variables. • Resident recruitment into primary care programs increased in high-need areas. • Primary care physician supply increased by 4 % in high-need areas.
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