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Browsing by Subject "Generational differences"
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Item Attitudes toward cost-conscious care among U.S. physicians and medical students: analysis of national cross-sectional survey data by age and stage of training(BMC, 2018-11-22) Leep Hunderfund, Andrea N.; Dyrbye, Liselotte N.; Starr, Stephanie R.; Mandrekar, Jay; Tilburt, Jon C.; George, Paul; Baxley, Elizabeth G.; Gonzalo, Jed D.; Moriates, Christopher; Goold, Susan D.; Carney, Patricia A.; Miller, Bonnie M.; Grethlein, Sara J.; Fancher, Tonya L.; Wynia, Matthew K.; Reed, Darcy A.; Medicine, School of MedicineBACKGROUND: The success of initiatives intended to increase the value of health care depends, in part, on the degree to which cost-conscious care is endorsed by current and future physicians. This study aimed to first analyze attitudes of U.S. physicians by age and then compare the attitudes of physicians and medical students. METHODS: A paper survey was mailed in mid-2012 to 3897 practicing physicians randomly selected from the American Medical Association Masterfile. An electronic survey was sent in early 2015 to all 5,992 students at 10 U.S. medical schools. Survey items measured attitudes toward cost-conscious care and perceived responsibility for reducing healthcare costs. Physician responses were first compared across age groups (30-40 years, 41-50 years, 51-60 years, and > 60 years) and then compared to student responses using Chi square tests and logistic regression analyses (controlling for sex). RESULTS: A total of 2,556 physicians (65%) and 3395 students (57%) responded. Physician attitudes generally did not differ by age, but differed significantly from those of students. Specifically, students were more likely than physicians to agree that cost to society should be important in treatment decisions (p < 0.001) and that physicians should sometimes deny beneficial but costly services (p < 0.001). Students were less likely to agree that it is unfair to ask physicians to be cost-conscious while prioritizing patient welfare (p < 0.001). Compared to physicians, students assigned more responsibility for reducing healthcare costs to hospitals and health systems (p < 0.001) and less responsibility to lawyers (p < 0.001) and patients (p < 0.001). Nearly all significant differences persisted after controlling for sex and when only the youngest physicians were compared to students. CONCLUSIONS: Physician attitudes toward cost-conscious care are similar across age groups. However, physician attitudes differ significantly from medical students, even among the youngest physicians most proximate to students in age. Medical student responses suggest they are more accepting of cost-conscious care than physicians and attribute more responsibility for reducing costs to organizations and systems rather than individuals. This may be due to the combined effects of generational differences, new medical school curricula, students' relative inexperience providing cost-conscious care within complex healthcare systems, and the rapidly evolving U.S. healthcare system.Item The Next Generation of Philanthropy(Indiana University Lilly Family School of Philanthropy, 2025)There is growing interest in understanding how Generation Z (also referred to as Gen Z) and Millennials will reshape the future philanthropic landscape. Often referred to as the next generation of donors, their story is still being written. Nonetheless, we already know that this unique group of young donors is influencing the sector in discernible ways. The Next Generation of Philanthropy report takes a close look at how the next generation approaches giving differently than the generations that came before them. The analysis provided for this study was derived using the Indiana University Lilly Family School of Philanthropy’s Philanthropy Panel Study, a module of the University of Michigan’s Panel Study of Income Dynamics, which has been tracking households since 2000. By following the same households over time, this longitudinal approach provides unique insights into changes in giving behavior by individuals and within households and families. This study shows that profound generational differences exist in giving to religious and secular causes. Collection of the Philanthropy Panel Study data within the Panel Study on Income Dynamics was begun in 2001 with funding from the Atlantic Philanthropies, with continuing waves funded by partnering donors; recent institutional donors include the Bill & Melinda Gates Foundation, Charles Stewart Mott Foundation, Fidelity Charitable Catalyst Fund, Givelify Foundation, Google. Org Charitable Giving Fund, and the John Templeton Foundation.