Watanabe Jonathan H
Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093-0657, USA.
Pharmacy (Basel). 2019 Sep 19;7(3):137. doi: 10.3390/pharmacy7030137.
The increasing number of pharmacists in the US has generated concern regarding potential oversupply. A 2018 analysis from the National Center for Health Workforce Analysis (NCHWA) in the US projected a best case scenario of an oversupply of more than 18,000 pharmacists in the year 2030. In this commentary, the limitations of this general health labor force analysis by the NCHWA are described. The goal of this work was to provide a more nuanced examination of the pharmacist labor demand in the US. Data from the US Bureau of Labor Statistics (BLS) and the US Medical Expenditure Panel Survey (MEPS) were utilized to examine, annually over a ten year period ending in 2017, the number of pharmacists, the ratio of pharmacists to persons living in the US, the ratio of pharmacists to older adults living in the US, and the ratio of medications to pharmacists. The number of pharmacists grew from 266,410 in 2008 to 309,330 in 2017. As anticipated, despite a growing US population, the ratio of people living in the US per pharmacist dropped unabated from 1141 to 1053 from 2008 to 2017, respectively. However, the reverse trend was observed for the ratio of persons 65 years or older per pharmacist. This ratio increased from 146.1 older adults to each pharmacist in 2008 to 164.3 in 2017. The accelerating demographic shift to an older population is also reversing an overall trend in the number of medications to pharmacist that will continue for the foreseeable future. While the ratio of medications to pharmacist dropped overall from 2008 to 2016, it has begun to rise again from 2016 to 2017. Beyond the increasing number of medications attributable to a rapidly aging population, there is a growing demand for clinical care from pharmacists due to the maturing environment of complex, costly medications for chronic disease treatment. As the portion of total health expenditure is increasingly devoted to medications and the US health delivery system continues its movement to community-based care, the demand for pharmacist care will require a larger number of pharmacists trained for advanced-practice care.
美国药剂师数量的不断增加引发了对潜在供应过剩的担忧。美国国家卫生人力分析中心（NCHWA）2018年的一项分析预测，到2030年，最佳情况下药剂师供应过剩将超过18000人。在这篇评论中，描述了NCHWA这项一般卫生人力分析的局限性。这项工作的目标是对美国药剂师劳动力需求进行更细致入微的审视。利用美国劳工统计局（BLS）和美国医疗支出小组调查（MEPS）的数据，在截至2017年的十年期间，每年对药剂师数量、药剂师与美国居住人口的比例、药剂师与美国老年人的比例以及药品与药剂师的比例进行考察。药剂师数量从2008年的266410人增长到2017年的309330人。正如预期的那样，尽管美国人口不断增长，但从2008年到2017年，每名药剂师对应的美国居住人口比例持续下降，分别从1141降至1053。然而，每名药剂师对应的65岁及以上人口比例却出现了相反的趋势。这一比例从2008年每名药剂师对应146.1名老年人增至2017年的164.3名。人口加速向老年化转变也正在扭转药品与药剂师数量的总体趋势，这一趋势在可预见的未来仍将持续。虽然从2008年到2016年药品与药剂师的比例总体下降，但从2016年到2017年又开始上升。除了因人口迅速老龄化导致药品数量增加外，由于用于慢性病治疗的复杂、昂贵药物环境日益成熟，对药剂师临床护理的需求也在不断增长。随着卫生总支出中用于药品的比例越来越高，且美国医疗服务体系继续向社区护理转变，对药剂师护理的需求将需要更多接受过高级实践护理培训的药剂师。
