The United States rheumatology workforce - Supply and demand, 2005-2025
The United States rheumatology workforce - Supply and demand, 2005-2025
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DOI：
10.1002/art.22437
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发表时间：
2007-02-01
影响因子：
--
通讯作者：
Barr, Walter
中科院分区：
文献类型：
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作者：
Deal, Chad L.;Hooker, Roderick;Barr, Walter
目的开发和应用一个模型，可以预测美国风湿病服务当前和未来的供需。方法利用当前医生的年龄和性别分布、退休率和死亡率、奖学金名额和填补率以及风湿病学家的执业模式开发了供应模型。使用马尔可夫投影模型来预测从 2005 年到 2025 年 5 年增量的需求。结果 2005 年美国成人患者的风湿病专家人数为 4,946 人。 44 岁以下的男性和女性风湿病专家分布均匀； 44岁以上，男性占多数。成人风湿病领域的女性比例预计将从 2005 年的 30.2% 增加到 2025 年的 43.6%。每年每位风湿病专家的平均就诊次数为男性风湿病专家 3,758 次，女性风湿病专家 2,800 次。假设 2005 年风湿病供需平衡，预计 2025 年风湿病专家的需求量将超过 2,576 名成人风湿病专家和 33 名儿童风湿病专家。需求过剩的主要因素是人口老龄化，这将增加患有风湿性疾病的人数，国内生产总值的增长，以及由于进入劳动力市场和退休人数固定而导致风湿病供应停滞。年轻风湿病学家和女性在未来劳动力中所占比例更大，他们的生产力也可能对供应产生重要影响。可能影响这些预测的未知影响包括技术进步、更有效的实践方法、保险报销的变化以及生活方式的改变。目前的数据表明，儿科风湿病学劳动力正在经历供需大幅过剩的情况。结论根据当前情况下的供需评估，预计未来几十年对风湿病学家的需求将超过供应。该行业适应不断变化的医疗保健环境的策略包括每年增加研究员数量、聘用更多的医师助理和执业护士以及提高执业效率。
ObjectiveTo develop and apply a model that allows prediction of current and future supply and demand for rheumatology services in the US.MethodsA supply model was developed using the age and sex distribution of current physicians, retirement and mortality rates, the number of fellowship slots and fill rates, and practice patterns of rheumatologists. A Markov projection model was used to project needs in 5‐year increments from 2005 to 2025.ResultsThe number of rheumatologists for adult patients in the US in 2005 is 4,946. Male and female rheumatologists are equally distributed up to age 44; above age 44, men predominate. The percent of women in adult rheumatology is projected to increase from 30.2% in 2005 to 43.6% in 2025. The mean number of visits per rheumatologist per year is 3,758 for male rheumatologists and 2,800 for female rheumatologists. Assuming rheumatology supply and demand are in equilibrium in 2005, the demand for rheumatologists in 2025 is projected to exceed supply by 2,576 adult and 33 pediatric rheumatologists. The primary factors in the excess demand are an aging population which will increase the number of people with rheumatic disorders, growth in the Gross Domestic Product, and flat rheumatology supply due to fixed numbers entering the workforce and to retirements. The productivity of younger rheumatologists and women, who will make up a greater percentage of the future workforce, may also have important effects on supply. Unknown effects that could influence these projections include technology advances, more efficient practice methods, changes in insurance reimbursements, and shifting lifestyles. Current data suggest that the pediatric rheumatology workforce is experiencing a substantial excess of demand versus supply.ConclusionBased on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include increasing the number of fellows each year, utilizing physician assistants and nurse practitioners in greater numbers, and improving practice efficiency.