Petterson Stephen M, Liaw Winston R, Tran Carol, Bazemore Andrew W
Robert Graham Center, Washington, DC.
Virginia Commonwealth University, Richmond, Virginia
Ann Fam Med. 2015 Mar;13(2):107-14. doi: 10.1370/afm.1760.
The purpose of this study was to calculate the projected primary care physician shortage, determine the amount and composition of residency growth needed, and estimate the impact of retirement age and panel size changes.
We used the 2010 National Ambulatory Medical Care Survey to calculate utilization of ambulatory primary care services and the US Census Bureau to project demographic changes. To determine the baseline number of primary care physicians and the number retiring at 66 years, we used the 2014 American Medical Association Masterfile. Using specialty board and American Osteopathic Association figures, we estimated the annual production of primary care residents. To calculate shortages, we subtracted the accumulated primary care physician production from the accumulated number of primary care physicians needed for each year from 2015 to 2035.
More than 44,000 primary care physicians will be needed by 2035. Current primary care production rates will be unable to meet demand, resulting in a shortage in excess of 33,000 primary care physicians. Given current production, an additional 1,700 primary care residency slots will be necessary by 2035. A 10% reduction in the ratio of population per primary care physician would require more than 3,000 additional slots by 2035, whereas changing the expected retirement age from 66 years to 64 years would require more than 2,400 additional slots.
To eliminate projected shortages in 2035, primary care residency production must increase by 21% compared with current production. Delivery models that shift toward smaller ratios of population to primary care physicians may substantially increase the shortage.
本研究旨在计算预计的初级保健医生短缺情况，确定所需住院医师增长的数量和构成，并评估退休年龄和患者量变化的影响。
我们使用2010年国家门诊医疗调查来计算门诊初级保健服务的利用率，并利用美国人口普查局来预测人口变化。为确定初级保健医生的基线数量以及66岁时退休的人数，我们使用了2014年美国医学协会主档案。利用专科委员会和美国骨疗法协会的数据，我们估算了初级保健住院医师的年产量。为计算短缺情况，我们从2015年至2035年每年所需的初级保健医生累计数量中减去初级保健医生的累计产量。
到2035年将需要超过44000名初级保健医生。当前的初级保健医生产量无法满足需求，导致初级保健医生短缺超过33000名。按照目前的产量，到2035年将需要额外增加1700个初级保健住院医师职位。初级保健医生与人口比例降低10%，到2035年将需要额外增加超过3000个职位，而将预期退休年龄从66岁改为64岁将需要额外增加超过2400个职位。
为消除2035年预计的短缺情况，初级保健住院医师产量必须比目前产量增加21%。向初级保健医生与人口比例更低的模式转变可能会大幅增加短缺情况。
