Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; University Hospital, San Antonio, TX, USA.
Am J Surg. 2013 Dec;206(6):1016-22; discussion 1022-3. doi: 10.1016/j.amjsurg.2013.07.018. Epub 2013 Oct 12.
Multiple studies have documented a significant decrease in the general surgery workforce in the United States, both rural and urban, for the past 3 decades. This 11-year study evaluates the Texas general surgery workforce at both the state and local level in 2002 and 2012.
Data were obtained from the Texas Medical Board, the United States Census Bureau/Texas State Library and Archives Commission, and the Texas Department of State Health Services for 2002 and 2012. A benchmark target of 7 general surgeons per 100,000 population was used.
During the study period, the Texas population increased 21%, and actively practicing physicians increased 44%. All surgical specialists increased by 26%. General surgeons increased 4%; however, the number of general surgeons per 100,000 population decreased 14% (from 6.7 to 5.8/10(5)). Using the total Texas population for 2012, an additional 329 general surgeons are needed by benchmark standards. However, when analyzed by individual county population, 449 additional general surgeons are needed in the individual counties. These effects were greater in the nonmetropolitan areas of Texas where per capita general surgeons decreased by 21%.
The absolute increase in Texas general surgeons over the past decade has not kept pace with an increase in the Texas population. The general surgery workforce deficit based on the Texas state population underestimates the local workforce shortage, particularly in the nonmetropolitan areas of Texas.
过去 30 年来，多项研究记录表明，美国农村和城市地区的普通外科医生数量都大幅减少。这项为期 11 年的研究评估了 2002 年和 2012 年德克萨斯州的普通外科医生在州和地方层面的情况。
数据来自德克萨斯州医学委员会、美国人口普查局/德克萨斯州立图书馆和档案馆委员会以及德克萨斯州州立卫生服务部，分别用于 2002 年和 2012 年。使用了每 10 万人中有 7 名普通外科医生的基准目标。
在研究期间，德克萨斯州的人口增加了 21%，活跃的执业医生增加了 44%。所有外科专家的数量增加了 26%。普通外科医生增加了 4%；然而，每 10 万人中的普通外科医生数量减少了 14%（从 6.7 减少到 5.8/10(5)）。根据 2012 年的德克萨斯州总人口，按照基准标准还需要增加 329 名普通外科医生。然而，当按个别县的人口进行分析时，个别县还需要增加 449 名普通外科医生。这些影响在德克萨斯州的非都市区更大，那里每千人的普通外科医生减少了 21%。
在过去十年中，德克萨斯州普通外科医生的绝对数量增加并没有跟上德克萨斯州人口的增长。基于德克萨斯州人口的普通外科医生劳动力短缺低估了当地劳动力短缺的情况，特别是在德克萨斯州的非都市区。
