Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
J Thorac Cardiovasc Surg. 2014 Jul;148(1):7-12. doi: 10.1016/j.jtcvs.2014.03.031. Epub 2014 Mar 26.
To develop a microsimulation model of thoracic surgery workforce supply and demand to forecast future labor requirements.
The Canadian Community Health Survey and Canadian Census data were used to develop a microsimulation model. The demand component simulated the incidence of lung cancer; the supply component simulated the number of practicing thoracic surgeons. The full model predicted the rate of operable lung cancers per surgeon according to varying numbers of graduates per year.
From 2011 to 2030, the Canadian national population will increase by 10 million. The lung cancer incidence rates will increase until 2030, then plateau and decline. The rate will vary by region (12.5% in Western Canada, 37.2% in Eastern Canada) and will be less pronounced in major cities (10.3%). Minor fluctuations in the yearly thoracic surgery graduation rates (range, 4-8) will dramatically affect the future number of practicing surgeons (range, 116-215). The rate of operable lung cancer varies from 35.0 to 64.9 cases per surgeon annually. Training 8 surgeons annually would maintain the current rate of operable lung cancer cases per surgeon per year (range, 32-36). However, this increased rate of training will outpace the lung cancer incidence after 2030.
At the current rate of training, the incidence of operable lung cancer will increase until 2030 and then plateau and decline. The increase will outstrip the supply of thoracic surgeons, but the decline after 2030 will translate into an excess future supply. Minor increases in the rate of training in response to short-term needs could be problematic in the longer term. Unregulated workforce changes should, therefore, be approached with care.
开发一个胸外科劳动力供需的微观模拟模型，以预测未来的劳动力需求。
使用加拿大社区健康调查和加拿大人口普查数据开发微观模拟模型。需求部分模拟肺癌的发病率；供应部分模拟从事胸外科的医生人数。全模型根据每年毕业生人数的不同，预测每位外科医生可手术肺癌的比例。
从 2011 年到 2030 年，加拿大全国人口将增加 1000 万。肺癌发病率将持续增加到 2030 年，然后趋于平稳并下降。该比率将因地区而异（加拿大西部为 12.5%，加拿大东部为 37.2%），在主要城市则不太明显（10.3%）。每年胸外科毕业率的微小波动（范围为 4-8）将极大地影响未来执业外科医生的数量（范围为 116-215）。可手术肺癌的比例每年从 35.0 例到 64.9 例不等。每年培训 8 名外科医生将维持当前每位外科医生每年可手术肺癌病例的比例（范围为 32-36）。然而，这种培训率的增加将超过 2030 年后的肺癌发病率。
以目前的培训速度，可手术肺癌的发病率将持续增加到 2030 年，然后趋于平稳并下降。增加速度将超过胸外科医生的供应，但 2030 年后的下降将导致未来供过于求。为短期需求而适度增加培训率在长期内可能会出现问题。因此，应谨慎对待不受监管的劳动力变化。
