Colenda Christopher C, Wilk Joshua E, West Joyce C
College of Medicine, 147 Joe H. Reynolds Medical Bldg., Texas A&M University System Health Science Center, College Station, TX 77845-1114, USA.
Am J Geriatr Psychiatry. 2005 Sep;13(9):756-65. doi: 10.1176/appi.ajgp.13.9.756.
Using the 2002 National Survey of Psychiatric Practice (NSPP), authors update demographic and professional work activities of a nationally representative sample of the psychiatric workforce who treat geriatric patients.
The sampling frame for the 2002 NSPP used the American Medical Association's Masterfile of Physicians. Professional, demographic, and patient data are compared between general and self-reported geriatric psychiatrists. Authors also present detailed analyses comparing high geriatric providers (HGPs; geriatric caseloads >20%), and board-certified geriatric psychiatrists (BCGPs).
The proportion of HGPs in the 2002 NSPP was 26.0% of all respondents and was 28.1% among American Psychiatric Association (APA)-member respondents. Among the APA-member psychiatrists, this reflected a 55% increase from the 1996 NSPP. Of HGPs, 31.0% were certified in geriatric psychiatry. As compared with general psychiatrists, proportionally fewer men and American medical-school graduates were self-reported geriatric psychiatrists. Geriatric psychiatrists saw nearly three times as many geriatric patients and five times as many dementia patients as did their generalist counterparts. Mood-disorder patients were the largest treatment group, however. Investigators observed no significant differences in professional and practice characteristics between HGPs and BCGPs.
About 1 in 4 psychiatrists in the 2002 survey are HGPs. Geriatric psychiatrists treat proportionally more geriatric patients than do generalists, but they do not have exclusively geriatric practices. The similarities between HGPs and BCGPs raise issues about the incentives for geriatric psychiatry certification, but not the need to train subspecialists to serve as faculty and community resources.
作者利用2002年全国精神病学实践调查(NSPP),更新了治疗老年患者的具有全国代表性的精神病学劳动力样本的人口统计学和专业工作活动情况。
2002年NSPP的抽样框架采用了美国医学协会的医师主文件。对普通精神病医生和自我报告的老年精神病医生的专业、人口统计学和患者数据进行了比较。作者还进行了详细分析,比较了高老年患者治疗比例的医生(HGPs;老年患者病例量>20%)和获得委员会认证的老年精神病医生(BCGPs)。
2002年NSPP中HGPs的比例占所有受访者的26.0%,在美国精神病学协会(APA)成员受访者中占28.1%。在APA成员精神病医生中,这一比例较1996年NSPP增长了55%。在HGPs中,31.0%获得了老年精神病学认证。与普通精神病医生相比,自我报告为老年精神病医生的男性和美国医学院毕业生比例相对较少。老年精神病医生诊治的老年患者数量几乎是普通医生的三倍,痴呆患者数量是普通医生的五倍。然而,情绪障碍患者是最大的治疗群体。研究人员观察到HGPs和BCGPs在专业和实践特征方面没有显著差异。
在2002年的调查中,约四分之一的精神病医生是HGPs。老年精神病医生诊治的老年患者比例比普通医生高,但他们并非只从事老年病治疗。HGPs和BCGPs之间的相似性引发了关于老年精神病学认证激励措施的问题,但并未涉及培训专科医生作为教员和社区资源的必要性。