2014年小儿骨科医疗人力：当前人力状况及未来预测

Pediatric Orthopaedic Workforce in 2014: Current Workforce and Projections for the Future.

作者信息

Sawyer Jeffrey R, Jones Kerwyn C, Copley Lawson A, Chambers Stephanie

机构信息

*Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN †Department of Orthopaedic Surgery, Akron Children's Hospital §Akron Children's Hospital, Akron, OH ‡Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX.

出版信息

J Pediatr Orthop. 2017 Jan;37(1):59-66. doi: 10.1097/BPO.0000000000000666.

DOI:10.1097/BPO.0000000000000666

PMID:26523700

Abstract

BACKGROUND

The changing nature of the United States (US) health care system has prompted debate concerning the physician supply. The basic questions are: do we have an adequate number of surgeons to meet current demands and are we training the correct number of surgeons to meet future demands? The purpose of this analysis was to characterize the current pediatric orthopaedic workforce in terms of supply and demand, both present and future.

METHODS

Databases were searched (POSNA, SF Match, KID, MGMA) to determine the current pediatric orthopaedic workforce and workforce distribution, as well as pediatric orthopaedic demand.

RESULTS

The number of active Pediatric Orthopaedic Society of North America (POSNA) members increased over the past 20 years, from 410 in 1993 to 653 in 2014 (155% increase); however, the density of POSNA members is not equally distributed, but correlates to population density. The number of estimated pediatric discharges, orthopaedic and nonorthopaedic, has remained relatively stable from 6,348,537 in 1997 to 5,850,184 in 2012. Between 2003 and 2013, the number of pediatric orthopaedic fellows graduating from Accreditation Council for Graduate Medical Education and non-Accreditation Council for Graduate Medical Education programs increased from 39 to 50 (29%), with a peak of 67 fellows (71%) in 2009.

DISCUSSION

Although predicting the exact need for pediatric orthopaedic surgeons (POS) is impossible because of the complex interplay among macroeconomic, governmental, insurance, and local factors, some trends were identified: the supply of POS has increased, which may offset the expected numbers of experienced surgeons who will be leaving the workforce in the next 10 to 15 years; macroeconomic factors influencing demand for physician services, driven by gross domestic product and population growth, are expected to be stable in the near future; expansion of the scope of practice for POS is expected to continue; and further similar assessments are warranted.

LEVEL OF EVIDENCE

Level II-economic and decision analysis.

摘要

背景

美国医疗保健系统性质的变化引发了关于医生供应的讨论。基本问题是：我们是否有足够数量的外科医生来满足当前需求，以及我们培养的外科医生数量是否正确以满足未来需求？本分析的目的是从当前和未来的供需角度描述儿科骨科劳动力的现状。

方法

检索数据库（POSNA、SF Match、KID、MGMA）以确定当前儿科骨科劳动力和劳动力分布以及儿科骨科需求。

结果

在过去20年中，北美儿科骨科学会（POSNA）活跃会员数量有所增加，从1993年的410人增加到2014年的653人（增长155%）；然而，POSNA会员的密度分布并不均匀，而是与人口密度相关。1997年至2012年期间，估计的儿科出院人数（包括骨科和非骨科）相对稳定，从6348537人降至5850184人。2003年至2013年期间，从毕业后医学教育认证委员会和非毕业后医学教育认证委员会项目毕业的儿科骨科研究员人数从39人增加到50人（增长29%），2009年达到峰值67人（增长71%）。

讨论

由于宏观经济、政府、保险和地方因素之间复杂的相互作用，虽然无法准确预测儿科骨科医生（POS）的具体需求，但确定了一些趋势：POS的供应有所增加，这可能抵消未来10至15年内即将离开该行业的经验丰富外科医生的预期数量；受国内生产总值和人口增长驱动的影响医生服务需求的宏观经济因素预计在不久的将来将保持稳定；预计POS的执业范围将继续扩大；并且有必要进行进一步类似的评估。