Ezzeddine Fatima M, Moe Tabitha, Ephrem Georges, Kay William Aaron
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Cardiology, University of Arizona College of Medicine, Phoenix, Arizona.
Congenit Heart Dis. 2019 Jul;14(4):511-516. doi: 10.1111/chd.12771. Epub 2019 Apr 4.
Delivery of care to the adult congenital heart disease (ACHD) population has been limited by a shortage in the ACHD physician resources. There is limited data regarding the adequacy of the ACHD physician resources in the United States and our population estimates are extrapolated from Canadian data. Therefore, we proposed to evaluate the adequacy of ACHD physician: patient ratios in the United States at both national and regional levels.
Data from the Adult Congenital Heart Association (ACHA) website along with metropolitan area and statewide population data from 2016 US Census Bureau estimates were analyzed. Physicians listed on the ACHA website were cross-referenced with ABIM to verify ACHD board certification status.
There are 115 self-identified ACHD programs and 418 self-identified ACHD physicians listed in the ACHA website. There are 320 board-certified ACHD cardiologists in the United States today, including 161 not listed in the ACHA website. Regarding ratios of ACHD-certified physicians to patients, the best served metropolitan statistical area (MSA) is Raleigh-Cary, NC, and the worst served MSA is Riverside-San Bernardino-Ontario, CA. The best served State is Washington, DC, and the worst served State is Indiana.
The ACHD population continues to grow, and the looming national physician shortage is likely to greatly affect the ability to meet the complex needs of this growing population. In order to bring the ACHD patient: physician ratio to 1000:1, a minimum of 170 additional ACHD board-certified physicians are needed now.
成人先天性心脏病（ACHD）患者的医疗服务受到ACHD医生资源短缺的限制。关于美国ACHD医生资源充足性的数据有限，我们的人口估计是根据加拿大数据推断出来的。因此，我们提议评估美国国家和地区层面ACHD医生与患者的比例是否充足。
分析了成人先天性心脏病协会（ACHA）网站的数据以及2016年美国人口普查局估计的大都市区和全州人口数据。将ACHA网站上列出的医生与美国内科医学委员会（ABIM）进行交叉核对，以核实ACHD委员会认证状态。
ACHA网站上列出了115个自我认定的ACHD项目和418名自我认定的ACHD医生。目前美国有320名获得委员会认证的ACHD心脏病专家，其中161名未在ACHA网站上列出。关于获得ACHD认证的医生与患者的比例，服务最好的大都市统计区（MSA）是北卡罗来纳州的罗利 - 卡里，服务最差的MSA是加利福尼亚州的河滨 - 圣贝纳迪诺 - 安大略。服务最好的州是华盛顿特区，服务最差的州是印第安纳州。
ACHD患者群体持续增长，即将出现的全国性医生短缺可能会极大地影响满足这一不断增长群体复杂需求的能力。为了使ACHD患者与医生的比例达到1000：1，现在至少还需要170名获得ACHD委员会认证的医生。
