Assessment of Emergency Physician Workforce Needs in the United States, 2005
Assessment of Emergency Physician Workforce Needs in the United States, 2005
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DOI：
10.1111/j.1553-2712.2008.00264.x
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发表时间：
2008-12-01
影响因子：
4.4
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中科院分区：
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目的是估计急诊医生（EP）的劳动力需求，同时考虑到美国急诊科（ed）的多样性和急诊医生供需的各种预测。2005年美国国家ED目录（http://www.emnet-usa.org）提供了4,828个美国ED的年度访问量。作者根据现有的急诊医学（EM）委员会认证的每股收益，加上新的董事会认证每股收益，减去死亡或退休的董事会认证每股收益，计算了年供应量。每个急诊科的需求是通过访问次数除以平均急诊科容量来估计的（基于2.8名患者/小时，40小时/周和34%的非临床时间）。模型假设每个ED中至少有1个EP应该24/7存在，这将需要每个ED至少5.35个全职当量（fte）。根据年度EP损耗估计，计算出最佳情况、最坏情况和中间情况的结果。2005年，大约有22,000名EM董事会认证的董事总经理，但需要40,000名董事总经理才能为所有4,828名董事总经理提供员工（满足55%的需求）。共有2492家（52%）急诊科的就诊次数达到了最低要求（5.35个），其中47%为农村急诊科。在不现实的情况下（没有人员流失），最好的情况是，到2019年，所有的急诊室都要配备董事会认证的董事总经理。在最坏的情况下（减员12%），供给永远无法满足需求。我们的中间情景（减员2.5%）表明，董事会认证的每股收益将在2038年满足劳动力需求。在不久的将来，新兴市场住院医师培训、董事会认证的EPs供应可能无法满足需求。其他的环境保护人员安排值得进一步考虑。
The objective was to estimate emergency physician (EP) workforce needs, taking into account the diversity of U.S. emergency departments (EDs) and various projections of EP supply and demand.The 2005 National ED Inventory-USA (http://www.emnet-usa.org) provided annual visit volumes for 4,828 U.S. EDs. The authors calculated annual supply based on existing emergency medicine (EM) board-certified EPs, adding newly board-certified EPs, and subtracting board-certified EPs who died or retired. Demand was estimated at each ED by dividing the number of visits by the average EP volume (based on 2.8 patients/hour, 40 hours/week, and 34% nonclinical time). The models assumed that at least 1 EP should be present 24/7 in each ED, which would require at least 5.35 full-time equivalents (FTEs) per ED. Based on annual EP attrition estimates, results for best-case, worst-case, and intermediate scenarios were calculated.In 2005, there were approximately 22,000 EM board-certified EPs, but 40,030 EPs would be needed to staff all 4,828 EDs (55% of demand met). A total of 2,492 (52%) EDs had a visit volume that required the minimum number (5.35) FTEs, of which 47% were rural. In the unrealistic (no attrition), best-case scenario, it would take until 2019 to staff all EDs with board-certified EPs. In the worst-case scenario (12% attrition), supply would never meet demand. Our intermediate scenario (2.5% attrition) suggested that board-certified EPs would satisfy workforce needs in 2038.Supply of EM residency-trained, board-certified EPs is not likely to meet demand in the near future. Alternative EP staffing arrangements merit further consideration.