Supply and demand analysis of the current and future US neurology workforce
Supply and demand analysis of the current and future US neurology workforce
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DOI：
10.1212/wnl.0b013e318294b1cf
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发表时间：
2013-07-30
期刊：
影响因子：
9.9
通讯作者：
Vidic, Thomas R.
中科院分区：
文献类型：
--
作者：
Dall, Timothy M.;Storm, Michael V.;Vidic, Thomas R.
目的：本研究估计了 2012 年至 2025 年全国和各州不同情景下当前和预测未来神经科医生的供需情况。方法：微观模拟供应模型模拟了神经科医生个体可能的职业选择，同时考虑到每年接受培训的新神经科医生的数量以及不断变化的神经科医生队伍的人口统计数据。微观模拟需求模型模拟每个州以及整个美国人口代表性样本中每个人对神经病学服务的利用情况。需求预测反映了与人口增长和老龄化相关的神经系统疾病患病率的增加，以及医疗保健改革覆盖范围的扩大。结果：预计 2012 年神经科医生的活跃供应量为 16,366 名，预计到 2025 年将增加到 18,060 名。患者就诊神经科医生的等待时间较长，难以雇用新的神经科医生，以及大量神经科医生不接受新的医疗补助患者，这与目前全国神经科医生的短缺是一致的。对神经科医生的需求预计将增加； 2012 年的 18,180 人（缺口 11%）到 2025 年为 21,440 人（缺口 19%）。这包括从 2014 年开始，由于与《患者保护和平价医疗法案》相关的医疗保险覆盖范围扩大，对 520 名全职同等神经科医生的需求增加。 结论：如果不努力增加神经病学专业人员的数量并留住现有劳动力，目前国家和地区神经科医生的短缺可能会加剧，从而加剧漫长的等待时间并减少医疗补助受益人获得护理的机会。当前供应充足性方面的地理差异可能会持续到未来。
Objective: This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025.Methods: A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of newneurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform.Results: The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from; 18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act.Conclusions: In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.