Rural practice preferences among medical students in Ghana: a discrete choice experiment.

OBJECTIVE: To determine how specific job attributes influenced fourth year medical students' stated preference for hypothetical rural job postings in Ghana. METHODS: Based on discussions with medical student focus groups and physicians in practice and in the Ministry of Health, we created a discrete...

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Publicado en:Bulletin of the World Health Organization Vol. 88; no. 5; pp. 333 - 342
Autores principales: Kruk ME, Johnson JC, Gyakobo M, Agyei-Baffour P, Asabir K, Kotha SR, Kwansah J, Nakua E, Snow RC, Dzodzomenyo M
Formato: equations & formulas research tables/charts Journal Article
Publicado: World Health Organization May2010
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Rural practice preferences among medical students in Ghana: a discrete choice experiment.
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          Kruk ME
          Johnson JC
          Gyakobo M
          Agyei-Baffour P
          Asabir K
          Kotha SR
          Kwansah J
          Nakua E
          Snow RC
          Dzodzomenyo M
        affil: Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights M3166 SPH II, Ann Arbor, MI 48109, United States of America. mkruk@umich.edu
      sug:
        subj:
          Employment Ghana
          Students, Medical Ghana
          Adult
          Chi Square Test
          Confidence Intervals
          Contracts
          Data Analysis Software
          Descriptive Statistics
          Employee Incentive Programs
          Exploratory Research
          Female
          Focus Groups
          Funding Source
          Ghana
          Housing
          Human
          Logistic Regression
          Male
          Questionnaires
          Rural Areas
          Salaries and Fringe Benefits
          Surveys
          Univariate Statistics
          Adult: 19-44 years
          Female
          Male
      ab: OBJECTIVE: To determine how specific job attributes influenced fourth year medical students' stated preference for hypothetical rural job postings in Ghana. METHODS: Based on discussions with medical student focus groups and physicians in practice and in the Ministry of Health, we created a discrete choice experiment (DCE) that assessed how students' stated preference for certain rural postings was influenced by various job attributes: a higher salary, free superior housing, an educational allowance for children, improved equipment, supportive management, shorter contracts before study leave and a car. We conducted the DCE among all fourth year medical students in Ghana using a brief structured questionnaire and used mixed logit models to estimate the utility of each job attribute. FINDINGS: Complete data for DCE analysis were available for 302 of 310 (97%) students. All attribute parameter estimates differed significantly from zero and had the expected signs. In the main effects mixed logit model, improved equipment and supportive management were most strongly associated with job preference (beta = 1.42; 95% confidence interval, CI: 1.17 to 1.66, and beta = 1.17; 95% CI: 0.96 to 1.39, respectively), although shorter contracts and salary bonuses were also associated. Discontinuing the provision of basic housing had a large negative influence (beta = -1.59; 95% CI: -1.88 to -1.31). In models including gender interaction terms, women's preferences were more influenced by supportive management and men's preferences by superior housing. CONCLUSION: Better working conditions were strongly associated with the stated choice of hypothetical rural postings among fourth year Ghanaian medical students. Studies are needed to find out whether job attributes determine the actual uptake of rural jobs by graduating physicians. © World Health Organization 2010. All rights reserved.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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