The Robert Graham Center, Policy Studies in Family Medicine and Primary Care, Washington, DC, USA.
Ann Fam Med. 2012 Nov-Dec;10(6):503-9. doi: 10.1370/afm.1431.
We sought to project the number of primary care physicians required to meet US health care utilization needs through 2025 after passage of the Affordable Care Act.
In this projection of workforce needs, we used the Medical Expenditure Panel Survey to calculate the use of office-based primary care in 2008. We used US Census Bureau projections to account for demographic changes and the American Medical Association's Masterfile to calculate the number of primary care physicians and determine the number of visits per physician. The main outcomes were the projected number of primary care visits through 2025 and the number of primary care physicians needed to conduct those visits.
Driven by population growth and aging, the total number of office visits to primary care physicians is projected to increase from 462 million in 2008 to 565 million in 2025. After incorporating insurance expansion, the United States will require nearly 52,000 additional primary care physicians by 2025. Population growth will be the largest driver, accounting for 33,000 additional physicians, while 10,000 additional physicians will be needed to accommodate population aging. Insurance expansion will require more than 8,000 additional physicians, a 3% increase in the current workforce.
Population growth will be the greatest driver of expected increases in primary care utilization. Aging and insurance expansion will also contribute to utilization, but to a smaller extent.
平价医疗法案通过后,我们旨在预测 2025 年之前满足美国医疗保健利用需求所需的初级保健医生数量。
在这项劳动力需求预测中,我们使用医疗支出面板调查来计算 2008 年的基层医疗保健办公室就诊量。我们使用美国人口普查局的预测来考虑人口变化,使用美国医学协会的主文件来计算初级保健医生的数量,并确定每位医生的就诊次数。主要结果是到 2025 年预计的初级保健就诊次数和进行这些就诊所需的初级保健医生数量。
受人口增长和老龄化的推动,预计到 2025 年,到初级保健医生办公室就诊的总人数将从 2008 年的 4.62 亿次增加到 5.65 亿次。在纳入保险扩张后,到 2025 年,美国将需要近 5.2 万名额外的初级保健医生。人口增长将是最大的驱动因素,占额外 3.3 万名医生,而人口老龄化将需要额外 1 万名医生来适应。保险扩张将需要增加 8000 多名医生,这将使现有劳动力增加 3%。
人口增长将是初级保健利用率预期增长的最大驱动因素。老龄化和保险扩张也将在一定程度上促进利用率的增长。