IHS Healthcare & Pharma, Washington, DC, USA.
Neurology. 2013 Jul 30;81(5):470-8. doi: 10.1212/WNL.0b013e318294b1cf. Epub 2013 Apr 17.
This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025.
A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform.
The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act.
In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.
本研究通过全国和各州的替代方案,估计从 2012 年到 2025 年的当前和未来神经科医生的供需情况。
一个微观模拟供应模型模拟了个别神经科医生可能的职业选择,考虑到每年培训的新神经科医生数量以及神经科劳动力的人口统计学变化。微观模拟需求模型模拟了每个州代表性人群中每个人的神经病服务利用情况,以及整个美国的情况。需求预测反映了与人口增长和老龄化相关的神经疾病患病率的增加,以及医疗保健改革下覆盖范围的扩大。
2012 年活跃的 16366 名神经科医生预计将增加到 2025 年的 18060 名。患者等待看神经科医生的时间长、难以招聘新神经科医生、以及大量不接受新医疗补助患者的神经科医生,这与当前全国范围内神经科医生短缺的情况一致。预计神经科医生的需求将从 2012 年的约 18180 名(短缺 11%)增加到 2025 年的 21440 名(短缺 19%)。这包括从 2014 年开始,由于与《患者保护与平价医疗法案》相关的医疗保险覆盖范围扩大,将增加 520 名全职当量的神经科医生。
如果不努力增加神经科专业人员的数量并留住现有劳动力,当前全国和地区性的神经科医生短缺情况可能会恶化,加剧患者的等待时间,并减少医疗补助受益人的获得护理的机会。未来可能会持续存在当前在供应充足性方面的地域差异。