Population-based analysis of inpatient vascular procedures and predicting future workload and implications for training
Population-based analysis of inpatient vascular procedures and predicting future workload and implications for training
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DOI：
10.1016/j.jvs.2011.11.061
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发表时间：
2012-05-01
影响因子：
4.3
通讯作者：
Rubin, Brian G.
中科院分区：
文献类型：
--
作者：
Jim, Jeffrey;Owens, Pamela L.;Rubin, Brian G.
目的：本研究的目的是分析过去十年美国住院血管手术的趋势，并预测未来对血管外科医生的需求。方法：查询全国住院患者样本，以确定1997年至2008年期间成人患者（年龄>= 18）住院血管手术的加权全国估计数。使用美国人口普查局的人口估计，计算了特定年龄组（18-64岁，65-84岁和>= 85岁）的人均住院率。过去十年来人均比率的变化以及人口预测被用来预测未来的工作量。结果：所有成人住院血管手术从1997年的971,046例增加到2008年的1188,332例，净增长22%。在同一时期，成年人口从1.98亿增加到2.3亿，增长了16%。所有血管手术的年龄分层人均比率为+21%，年龄为18至64岁；65至84岁-4%；85岁+18%。这导致所有成年人的人均比率净增5%（每10万人490至515例）。基于特定年龄比率的趋势保持不变的假设，预计到2015年住院工作量将增加18%（与2008年相比），到2020年将增加34%，到2030年将增加72%。预计到2040年，血管负荷将增加一倍以上。结论：尽管保守的方法是只使用基于人群的住院手术分析，但未来预测的血管负荷显著增加。血管外科培训过程需要适应，以确保有足够数量的研究金培训血管外科医生可以在未来提供高质量的血管护理。[J] .中华外科杂志，2012;55:1394-1400。]
Objective: The purpose of this study was to analyze the trend in inpatient vascular procedures in the United States over the past decade and predict the future demand for vascular surgeons.Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried to determine the weighted national estimates of inpatient vascular procedures performed on adult patients (age >= 18) between 1997 and 2008. Using population estimates from the United States Census Bureau, the per capita rates of inpatient procedures were calculated for age-specific groups (18-64 years, 65-84 years, and >= 85 years). The change in per capita rates over the past decade along with population forecasts were used to predict future workload.Results: There was a net increase of 22% from 971,046 inpatient vascular procedures for all adults in 1997 to 1,188,332 in 2008. During the same time period, the adult population increased by 16% from 198 to 230 million. The age-stratified per capita rates of all vascular procedures were +21% for age 18 to 64; -4% for age 65 to 84; and +18% for age >= 85. This resulted in a net increase of 5% (490 to 515 procedures per 100,000 capita) in the per capita rate for all adults. Based on the assumption that trends in age-specific rates remain constant, there is a predicted inpatient workload increase (compared to 2008) of 18% by 2015, 34% by 2020, and 72% by 2030. The vascular workload is predicted to more than double by the year 2040.Conclusions: Despite a conservative approach of using a population-based analysis of only inpatient procedures, there is a dramatic increase in the predicted vascular workload for the future. The vascular surgery training process will need to adapt to ensure an adequate number of fellowship-trained vascular surgeons is available to provide quality vascular care in the future. (J Vasc Surg 2012;55:1394-1400.)