Healthcare educational debt in the united states: unequal economic impact within interprofessional team members

BMC Medical Education

Research

Bridget E. Shields¹  Manish Suneja²  Josef N. Tofte³  Richard K. Shields⁴  Shauna Dudley-Javoroski⁴ 

[1]Department of Dermatology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

[2]Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA

[3]Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

[4]Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, 1-252 Medical Education Building, 52242, Iowa City, IA, USA

关键词: Interprofessional;    Debt;    Education;    Salary;    Economics;    Allied health occupations;    Health workforce;    Minority groups;    Ethnic and racial minorities;    Sexual and gender minorities;   

DOI  :  10.1186/s12909-023-04634-1

 received in 2023-06-01, accepted in 2023-08-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAdvancing healthcare access and quality for underserved populations requires a diverse, culturally competent interprofessional workforce. However, high educational debt may influence career choice of healthcare professionals. In the United States, health professions lack insight into the maximum educational debt that can be supported by current entry-level salaries. The purpose of this interprofessional economic analysis was to examine whether average educational debt for US healthcare graduates is supportable by entry-level salaries. Additionally, the study explored whether trainees from minoritized backgrounds graduate with more educational debt than their peers in physical therapy.MethodsThe study modeled maximum educational debt service ratios for 12 healthcare professions and 6 physician specialties, incorporating profession-specific estimates of entry-level salary, salary growth, national average debt, and 4 loan repayment scenarios offered by the US Department of Education Office of Student Financial Aid. Net present value (NPV) provided an estimate for lifetime “economic power” for the modeled careers. The study used a unique data source available from a single profession (physical therapy, N = 4,954) to examine whether educational debt thresholds based on the repayment model varied between minoritized groups and non-minoritized peers.ResultsHigh salary physician specialties (e.g. obstetrics/gynecology, surgery) and professions without graduate debt (e.g. registered nurse) met debt ratio targets under any repayment plan. Professions with strong salary growth and moderate debt (e.g. physician assistant) required extended repayment plans but had high career NPV. Careers with low salary growth and high debt relative to salary (e.g. physical therapy) had career NPV at the lowest range of modeled professions. 29% of physical therapy students graduated with more debt than could be supported by entry-level salaries. Physical therapy students from minoritized groups graduated with 10–30% more debt than their non-minoritized peers.ConclusionsGraduates from most healthcare professions required extended repayment plans (higher interest) to meet debt ratio benchmarks. For several healthcare professions, low debt relative to salary protected career NPV. Students from minoritized groups incurred higher debt than their peers in physical therapy.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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