The Lewin Group, Falls Church; American Society of Clinical Oncology, Alexandria, VA; South Texas Oncology and Hematology, San Antonio, TX; Scripps Clinic, La Jolla, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; and Beth Israel Deaconess Medical Center, Boston, MA.
J Oncol Pract. 2014 Jan;10(1):39-45. doi: 10.1200/JOP.2013.001319.
The American Society of Clinical Oncology (ASCO) published a study in 2007 that anticipated a shortage of oncologists by 2020. This study aims to update and better assess the market for chemotherapy and radiation therapy and the impact of health reform on capacity of and demand for oncologists and radiation oncologists.
The supply of oncologists and radiation oncologists, by age, sex, and specialty, was projected through 2025 with an input-output model. The Medical Expenditure Panel Survey, commercial claims, and Medicare claims were analyzed to determine patterns of use by patient characteristics such as age, sex, health insurance coverage, cancer site, physician specialty, and service type. Patterns of use were then applied to the projected prevalence of cancer, using data from the SEER Program of the National Cancer Institute.
Beginning in 2012, 16,347 oncologists and radiation oncologists were active and supplying 15,190 full-time equivalents (FTEs) of patient care. Without consideration of the Affordable Care Act (ACA), overall demand for oncologist services is projected to grow 40% (21,255 FTEs), whereas supply may grow only 25% (18,997 FTEs), generating a shortage of 2,258 FTEs in 2025. When fully implemented, the ACA could increase the demand for oncologists and radiation oncologists by 500,000 visits per year, increasing the shortage to 2,393 FTEs in 2025.
Anticipated shortages are largely consistent with the projections of the ASCO 2007 workforce study but somewhat more delayed. The ACA may modestly exacerbate the shortage. Unless oncologist productivity can be enhanced, the anticipated shortage will strain the ability to provide quality cancer care.
美国临床肿瘤学会（ASCO）在 2007 年发表了一项研究，预计到 2020 年将出现肿瘤学家短缺。本研究旨在更新并更好地评估化疗和放疗市场，以及医疗改革对肿瘤学家和放射肿瘤学家的供应能力和需求的影响。
通过投入产出模型预测 2025 年前肿瘤学家和放射肿瘤学家的年龄、性别和专业供应情况。对医疗保险支出调查、商业索赔和医疗保险索赔进行了分析，以确定按患者特征（如年龄、性别、医疗保险覆盖范围、癌症部位、医生专业和服务类型）使用模式。然后，根据国家癌症研究所 SEER 计划的数据，将使用模式应用于预测的癌症发病率。
从 2012 年开始，有 16347 名肿瘤学家和放射肿瘤学家活跃，提供 15190 个全职等效（FTE）的患者护理。如果不考虑《平价医疗法案》（ACA），预计对肿瘤学家服务的总需求将增长 40%（21255 个 FTE），而供应可能仅增长 25%（18997 个 FTE），到 2025 年将短缺 2258 个 FTE。当 ACA 全面实施时，每年可能会增加 50 万名肿瘤学家和放射肿瘤学家的需求，到 2025 年短缺将增加到 2393 个 FTE。
预计的短缺与 ASCO 2007 年劳动力研究的预测基本一致，但略有延迟。ACA 可能会略微加剧短缺。除非肿瘤学家的生产力能够提高，否则预计的短缺将给提供高质量癌症护理的能力带来压力。
