WWAMI Rural Health Research Center, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington.
WWAMI Rural Health Research Center, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington.
Am J Prev Med. 2018 Jun;54(6 Suppl 3):S199-S207. doi: 10.1016/j.amepre.2018.01.004.
In 2015, an estimated 43.4 million Americans aged 18 and older suffered from a behavioral health issue. Accurate estimates of the number of psychiatrists, psychologists, and psychiatric nurse practitioners are needed as demand for behavioral health care grows.
The National Plan and Provider Enumeration System National Provider Identifier data (October 2015) was used to examine the supply of psychiatrists, psychologists, and psychiatric nurse practitioners. Providers were classified into three geographic categories based on their practicing county (metropolitan, micropolitan, and non-core). Claritas 2014 U.S. population data were used to calculate provider-to-population ratios for each provider type. Analysis was completed in 2016.
Substantial variation exists across Census Divisions in the per capita supply of psychiatrists, psychologists, and psychiatric nurse practitioners. The New England Census Division had the highest per capita supply and the West South Central Census Division had among the lowest supply of all three provider types. Nationally, the per capita supply of these providers was substantially lower in non-metropolitan counties than in metropolitan counties, but Census Division disparities persisted across geographic categories. There was a more than tenfold difference in the percentage of counties lacking a psychiatrist between the New England Census Division (6%) and the West North Central Census Division (69%). Higher percentages of non-metropolitan counties lacked a psychiatrist.
Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S. Disparities exist across Census Divisions and geographic categories. Understanding this unequal distribution is necessary for developing approaches to improving access to behavioral health services for underserved populations.
This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services.
2015 年，估计有 4340 万 18 岁及以上的美国人患有行为健康问题。随着对行为健康护理需求的增长，需要准确估计精神病医生、心理学家和精神科执业护士的数量。
使用国家计划和提供者枚举系统国家提供者标识符数据（2015 年 10 月），研究精神病医生、心理学家和精神科执业护士的供应情况。根据其执业县（大都市区、小都市区和非核心区），将提供者分为三类地理类别。使用 2014 年克拉里塔斯美国人口数据计算每种提供者类型的提供者与人口的比例。分析于 2016 年完成。
在每个精神病医生、心理学家和精神科执业护士的人均供应量方面，在人口普查区之间存在很大差异。新英格兰人口普查区的人均供应量最高，而中西部人口普查区的三种提供者类型的供应量最低。在全国范围内，这些提供者的人均供应量在非大都市区的县明显低于大都市区的县，但在地理类别上，人口普查区的差异仍然存在。在新英格兰人口普查区（6%）和中西部北部人口普查区（69%）之间，缺乏精神病医生的县的百分比差异超过十倍。非大都市区的县缺乏精神病医生的比例更高。
精神病医生、心理学家和精神科执业护士在美国的分布不均。在人口普查区和地理类别之间存在差异。了解这种分布不均对于制定方法改善服务不足人群获得行为健康服务的机会是必要的。
本文是题为“行为健康劳动力：规划、实践和准备”的增刊的一部分，该增刊由美国卫生与公众服务部下属的物质滥用和精神健康服务管理局以及卫生资源和服务管理局赞助。
