Sosa Julie Ann, Wang Tracy S, Yeo Heather L, Mehta Pritesh J, Boudourakis Leon, Udelsman Robert, Roman Sanziana A
Section of Endocrine Surgery, Department of Surgery, Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Conn., USA.
Surgery. 2007 Dec;142(6):876-83. doi: 10.1016/j.surg.2007.09.005. Epub 2007 Oct 29.
There has been an increase in the incidence of endocrine diseases and the number of endocrine procedures in the United States. Higher surgeon volume is associated with improved patient outcomes. Fellowship programs will lead to more specialty-trained endocrine surgeons. We make projections for the supply of endocrine surgeons and demand for endocrine procedures over the next 15 years.
Supply projections are based on data from the Accreditation Council for Graduate Medical Education, a survey of American Association of Endocrine Surgery fellowship program graduates, and Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS). Demand is estimated using HCUP-NIS, U.S. Census Bureau projections, and a literature review.
There were 64,275 endocrine procedures performed in 2000 and 80,505 in 2004. Using age-adjusted population projections and increasing incidence of endocrine diseases, 103,704 endocrine procedures are anticipated in 2020. High-volume endocrine surgeons are few in number, but perform 24% of endocrine procedures. Surgeon supply is projected to increase to 938 by 2020; this is based on fellowship graduation rates, retirement trends, and increasing annual endocrine case volume among high-volume surgeons. Alternative projections of supply and demand are generated to test the sensitivity of our analyses to different assumptions.
Labor force planning in endocrine surgery is essential if the demand for more high-volume endocrine specialists is to be met.
在美国，内分泌疾病的发病率和内分泌手术的数量均有所增加。外科医生手术量越大，患者预后越好。专科培训项目将培养出更多经过专科培训的内分泌外科医生。我们对未来15年内分泌外科医生的供应情况以及内分泌手术的需求进行了预测。
供应预测基于毕业后医学教育认证委员会的数据、对美国内分泌外科学会专科培训项目毕业生的一项调查以及医疗成本与利用项目国家住院患者样本（HCUP-NIS）。需求是通过HCUP-NIS、美国人口普查局的预测以及文献综述来估计的。
2000年共进行了64,275例内分泌手术，2004年为80,505例。根据年龄调整后的人口预测以及内分泌疾病发病率的上升，预计2020年将进行103,704例内分泌手术。高手术量的内分泌外科医生数量较少，但完成了24%的内分泌手术。预计到2020年外科医生供应量将增至938名；这是基于专科培训毕业率、退休趋势以及高手术量外科医生每年内分泌病例量的增加得出的。生成了供需的替代预测，以检验我们的分析对不同假设的敏感性。
如果要满足对更多高手术量内分泌专科医生的需求，内分泌外科的劳动力规划至关重要。
