The issues of the cost versus benefit and the service versus education about medical education programs have been raised and discussed mainly in the inpatient settings. This study proposes to examine the role of medical education in primary care in health centers whose clienteles are mostly from the low-income population group and where the physicians are employed on a salary basis mostly financed by the federal grants.
The principal objective of this study is to investigate the effects of medical education programs on the costs and productivity of health centers. The cost effects of medical education programs are estimated by comparing the differences in the unit costs of various categories between health centers with medical education programs and those without them. Then, a hypothetisized factors affecting the health center cost was analyzed.
The result shows that the health centers with medical educational programs have less health service cost per health service encounter. There was no significant difference in the other categories of cost of health centers. Also, the result shows the multi-level processes through which medical education programs influence the unit cost and personnel productivity of health centers.
의료기관의 원가에 관련된 대부분의 기존 연구가 병원을 비롯한 2차, 3차 의료기관을 중심으로 이루어져 왔다. 본 논문에서는 1차 진료기관이자, 상대적으로 저소득층 환자가 많이 이용하고 있는 미국의 헬스센터에 있어서 교육프로그램이 원가 및 생산성에 미치는 영향에 대해 살펴보았다.
교육프로그램을 실시하고 있는 헬스센터와 실시하고 있지 않은 헬스센터 두 집단 간의 비교 분석을 통해 다양한 의료 서비스 분야에 있어서 원가 및 생산성의 차이를 비교할 수 있었다. 또한 경로분석과 다변량 분석 등을 통해 교육프로그램이 헬스센터의 운영 구조를 변화시키거나 생산성을 향상시킴으로서 원가에 영향을 끼치는 단계적 과정을 확인할 수 있었다.
