The Lewin Group, Falls Church, VA, USA.
Public Health Rep. 2011 Sep-Oct;126(5):708-16. doi: 10.1177/003335491112600513.
A component of health-care reform in 2010 identified physician assistants (PAs) as needed to help mitigate the expected doctor shortage. We modeled their number to predict rational estimates for workforce planners.
The number of PAs in active clinical practice in 2010 formed the baseline. We used graduation rates and program expansion to project annual growth; attrition estimates offset these amounts. A simulation model incorporated historical trends, current supply, and graduation amounts. Sensitivity analyses were conducted to systematically adjust parameters in the model to determine the effects of such changes.
As of 2010, there were 74,476 PAs in the active workforce. The mean age was 42 years and 65% were female. There were 154 accredited educational programs; 99% had a graduating class and produced an average of 44 graduates annually (total n=6,776). With a 7% increase in graduate entry rate and a 5% annual attrition rate, the supply of clinically active PAs will grow to 93,099 in 2015, 111,004 in 2020, and 127,821 in 2025. This model holds clinically active PAs in primary care at 34%.
The number of clinically active PAs is projected to increase by almost 72% in 15 years. Attrition rates, especially retirement patterns, are not well understood for PAs, and variation could affect future supply. While the majority of PAs are in the medical specialties and subspecialties fields, new policy steps funding PA education and promoting primary care may add more PAs in primary care than the model predicts.
2010 年医疗改革的一个组成部分确定了需要医生助理(PA)来帮助缓解预期的医生短缺。我们对其数量进行了建模,以预测对劳动力规划者的合理估计。
2010 年活跃临床实践中的 PA 数量为基线。我们使用毕业率和项目扩展来预测年度增长;离职估计数抵消了这些数量。一个模拟模型纳入了历史趋势、当前供应和毕业数量。进行了敏感性分析,以系统地调整模型中的参数,以确定这些变化的影响。
截至 2010 年,活跃劳动力中有 74476 名 PA。平均年龄为 42 岁,65%为女性。有 154 个认可的教育项目;99%有毕业班级,每年平均产生 44 名毕业生(总计 n=6776)。随着研究生入学率增加 7%,每年离职率为 5%,活跃临床 PA 的供应量将在 2015 年增长到 93099 人,2020 年增长到 111004 人,2025 年增长到 127821 人。该模型将临床活跃的 PA 保留在初级保健中占 34%。
在 15 年内,活跃临床 PA 的数量预计将增加近 72%。PA 的离职率,特别是退休模式,尚未得到很好的理解,这种变化可能会影响未来的供应。虽然大多数 PA 都在医学专业和亚专业领域,但新的政策步骤资助 PA 教育和促进初级保健可能会增加比模型预测更多的初级保健中的 PA。