Workforce projections for emergency medicine: How many emergency physicians does the United States need?
Workforce projections for emergency medicine: How many emergency physicians does the United States need?
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DOI：
10.1111/j.1553-2712.1997.tb03768.x
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发表时间：
1997-07-01
影响因子：
4.4
通讯作者：
Hirshberg, AJ
中科院分区：
文献类型：
--
作者：
Holliman, CJ;Wuerz, RC;Hirshberg, AJ
目的：对不同劳动力条件下急诊医生 (EP) 的供需情况进行数学建模。方法：使用计算机电子表格模型来预测到 2035 年的年度 EP 劳动力供需情况。所使用的数学方程为：供给 = 年初的 EP 人数加上每年的住院医师毕业生人数减去年度人员流失；需求 = 5 个全职同等职位/急诊科 X 医院急诊科的数量。根据经验，需求有所不同，以考虑急诊科普查差异、行政和教学责任以及医生扩展人员的可用性。测试了各种可能的场景。这些预测假设急诊医学 (EM) 住院医师毕业生将优先填补目前由未经 EM 委员会认证的 EP 担任的临床职位。 结果：根据大多数测试情景，在下个世纪，经过 EM 委员会认证的 EP 将会出现大量短缺。即使在涉及对 EP 的“需求”减少的情况下（例如，在医院关闭或医师扩展培训的情况下），重大赤字也将持续至少几十年。结论：在美国医疗保健系统的任何重组期间，EM 住院医师职位的数量不应减少。新兴市场很可能仍然是一个专业，在未来几十年内，即使以目前的新兴市场住院医师输出水平，委员会认证的 EP 的供应也将无法满足需求。
Objective: To mathematically model the supply of and demand for emergency physicians (EPs) under different workforce conditions.Methods: A computer spreadsheet model was used to project annual EP workforce supply and demand through the year 2035. The mathematical equations used were: supply = number of EPs at the beginning of the year plus annual residency graduates minus annual attrition; demand = 5 full-time equivalent positions/ED X the number of hospital EDs. The demand was empirically varied to account for ED census variation, administrative and teaching responsibilities, and the availability of physician extenders. A variety of possible scenarios were tested. These projections make the assumption that emergency medicine (EM) residency graduates will preferentially fill clinical positions currently filled by EPs without EM board certification.Results: Under most of the scenarios tested, there will be a large deficit of EM board-certified EPs well into the next century. Even in scenarios involving a decreasing ''demand'' for EPs (e.g., in the setting of hospital closures or the training of physician extenders), a significant deficit will remain for at least several decades.Conclusions: The number of EM residency positions should not be decreased during any restructuring of the U.S. health care system. EM is likely to remain a specialty in which the supply of board-certified EPs will not meet the demand, even at present levels of EM residency output, for the next several decades.