A Workforce Survey on Developmental-Behavioral Pediatrics
A Workforce Survey on Developmental-Behavioral Pediatrics
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DOI：
10.1542/peds.2017-2164
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发表时间：
2018-03-01
期刊：
影响因子：
8
通讯作者：
Roizen, Nancy
中科院分区：
文献类型：
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作者：
Bridgemohan, Carolyn;Bauer, Nerissa S.;Roizen, Nancy
背景和后果：发展行为条件是常见的，影响到15%的美国儿童。尽管等待时间长，新的供应商渠道有限，但这些情况的普遍性和复杂性正在增加。我们调查了一个方便的样本的发展行为儿科（DBP）的劳动力，以确定目前的做法，劳动力的趋势，和未来的需求。一项电子调查通过电子邮件发送给了美国儿科学会发育和行为儿科学分会和残疾儿童理事会、发育和行为儿科学会的1568名成员，和全国儿科护士执业协会发展和行为心理健康特别兴趣小组。结果：应答率为48%。有411名研究员培训的医生，147名非研究员培训的医生和125名执业护士; 61%是女性，79%是白色，5%是西班牙裔。医生从医学院毕业后平均有29年的时间，三分之一的人计划在3到5年内退休。护士从业人员在他们的职业生涯中更早。受访者报告说，新的预约等待时间长，临床医生倦怠，增加病人的复杂性和高达50%的额外时间花费在每次访问的非报销临床护理活动。女性专科医生每次访问花费更多的时间在billable和nonbillable组成部分的clinical care.CONCLUSIONS：DBP劳动力的斗争，以满足当前的服务需求，长时间等待预约，增加的复杂性，和大量的nonrecovered护理。在今后的规划中必须考虑到基于性别的做法差异。DBP亚专业的可行性需要战略，以保持和扩大劳动力，提高临床效率，并防止倦怠。
BACKGROUND AND OBJECTIVES: Developmental-behavioral conditions are common, affecting similar to 15% of US children. The prevalence and complexity of these conditions are increasing despite long wait times and a limited pipeline of new providers. We surveyed a convenience sample of the developmental-behavioral pediatric (DBP) workforce to determine current practices, workforce trends, and future needs.METHODS: An electronic survey was e-mailed to 1568 members of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities, the Society for Developmental and Behavioral Pediatrics, and the National Association of Pediatric Nurse Practitioners Developmental and Behavioral Mental Health Special Interest Group.RESULTS: The response rate was 48%. There were 411 fellowship-trained physicians, 147 nonfellowship-trained physicians, and 125 nurse practitioners; 61% were women, 79% were white, and 5% were Hispanic. Physicians had a mean of 29 years since medical school graduation, and one-third planned to retire in 3 to 5 years. Nurse practitioners were earlier in their careers. Respondents reported long wait times for new appointments, clinician burnout, increased patient complexity and up to 50% additional time spent per visit in nonreimbursed clinical-care activities. Female subspecialists spent more time per visit in billable and nonbillable components of clinical care.CONCLUSIONS: The DBP workforce struggles to meet current service demands, with long waits for appointments, increased complexity, and high volumes of nonreimbursed care. Sexbased practice differences must be considered in future planning. The viability of the DBP subspecialty requires strategies to maintain and expand the workforce, improve clinical efficiency, and prevent burnout.