Native Hawaiian physician location and service to the underserved in Hawai'i.
This study examined the influence of demographic characteristics, training location, and "practice values" on geographic practice location and serving a medically underserved area/population (MUAP) among physicians of Native Hawaiian ancestry practicing within the State of Hawai'i. A survey assessing factors influencing practice location was mailed to 104 identified Native Hawaiian physicians in the State of Hawai'i with a response rate of 79% (n = 82). Factor analysis was used to identify underlying "practice value" variables important in physician practice location, resulting in three robust factors: (1) professional opportunity, (2) lifestyle, and (3) service. Data were analyzed using chi square, analyses of variance, and logistic regressions. Seventy-eight percent of the Native Hawaiian physicians sampled specialized in primary care, which is significantly more than in the general physician population in Hawai'i (57.3%) and in the continental United States (33.1%). Despite not being located in a MUAP, over half of the physicians felt that they provided important services to their medically underserved patients. Logistic regression models predicted 42% of the variance in practice location and 52% of the variance in serving a MUAP. In general, professional opportunity may be more important for non-MUAP physicians whereas service value may be more essential for MUAP physicians. Additional implications and further research are discussed.
Department of Psychiatry, University of Hawai'i at Manoa, Honolulu 96813, USA. else@hawaii.edu
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D001291:Attitude of Health Personnel; D005006:Ethnicity; D005163:Factor Analysis, Statistical; D005260:Female; D006254:Hawaii; D019538:Health Care Surveys; D006302:Health Services Research; D006303:Health Services, Indigenous; D006801:Humans; D008019:Life Style; D008297:Male; D008507:Medically Underserved Area; D010820:Physicians / Q000523:psychology / Q000600:supply & distribution*; D011320:Primary Health Care; D011365:Professional Practice Location; D000078329:Workforce