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一个更新后的医生劳动力模型预测,未来20年血管外科医生将短缺。

An Updated Physician Workforce Model Predicts a Shortage of Vascular Surgeons for the Next 20 Years.

作者信息

Go Michael R, Oslock Wendelyn M, Way David P, Baselice Holly E, Tamer Robert M, Kent K Craig, Williams Thomas E, Satiani Bhagwan

机构信息

Division of Vascular Diseases and Surgery, Department of Surgery, The Ohio State University, Columbus, OH.

Division of Vascular Diseases and Surgery, Department of Surgery, The Ohio State University, Columbus, OH.

出版信息

Ann Vasc Surg. 2020 Jul;66:282-288. doi: 10.1016/j.avsg.2020.01.097. Epub 2020 Feb 3.

Abstract

BACKGROUND

Concern regarding the adequacy of the vascular surgery workforce persists. We aimed to predict future vascular surgery workforce size and capacity using contemporary data on the US population and number, productivity, and practice patterns of vascular surgeons.

METHODS

The workforce size needed to maintain current levels of access was estimated to be 1.4 vascular surgeons/100,000 population. Updated population estimates were obtained from the US Census Bureau. We calculated future vascular surgery workforce needs based on the estimated population for every 10 years from 2020 to 2050. American Medical Association Physician Masterfile data from 1997 to 2017 were used to establish the existing vascular surgery workforce size and predict future workforce size, accounting for annual rates of new certificates (increased to an average of 133/year since 2013), retirement (17%/year), and the effects of burnout, reduced work hours, transitions to nonclinical jobs, or early retirement. Based on Medical Group Management Association data that estimate median vascular surgeon productivity to be 8,481 work relative value units (wRVUs)/year, excess/deficits in wRVU capacity were calculated based on the number of anticipated practicing vascular surgeons.

RESULTS

Our model predicts declining shortages of vascular surgeons through 2040, with workforce size meeting demand by 2050. In 2030, each surgeon would need to increase yearly wRVU production by 22%, and in 2040 by 8%, to accommodate the workload volume.

CONCLUSIONS

Our model predicts a shortage of vascular surgeons in the coming decades, with workforce size meeting demand by 2050. Congruence between workforce and demand for services in 2050 may be related to increases in the number of trainees from integrated residencies combined with decreases in population estimates. Until then, vascular surgeons will be required to work harder to accommodate the workload. Burnout, changing practice patterns, geographic maldistribution, and expansion of health care coverage and utilization may adversely affect the ability of the future workforce to accommodate population needs.

摘要

背景

对血管外科医生人力是否充足的担忧一直存在。我们旨在利用有关美国人口以及血管外科医生数量、生产力和执业模式的当代数据,预测未来血管外科医生的人力规模和能力。

方法

维持当前医疗可及水平所需的人力规模估计为每10万人口有1.4名血管外科医生。更新后的人口估计数来自美国人口普查局。我们根据2020年至2050年每10年的估计人口数计算未来血管外科医生的人力需求。利用1997年至2017年美国医学协会医生主文件数据确定现有的血管外科医生人力规模,并预测未来的人力规模,同时考虑新证书颁发的年增长率(自2013年起增至平均每年133份)以及退休率(每年17%),还有职业倦怠、工作时长减少、向非临床工作岗位转变或提前退休的影响。根据医疗集团管理协会的数据,血管外科医生的生产力中位数估计为每年8481个工作相对价值单位(wRVUs),根据预期执业血管外科医生的数量计算wRVU能力的过剩/不足情况。

结果

我们的模型预测,到2040年血管外科医生短缺情况将有所缓解,到2050年人力规模将满足需求。2030年,每位外科医生需要将每年的wRVU产量提高22%,到2040年提高8%,以应对工作量。

结论

我们的模型预测,未来几十年血管外科医生将出现短缺,到2050年人力规模将满足需求。2050年人力与服务需求之间达到一致,可能与综合住院医师培训学员数量增加以及人口估计数减少有关。在此之前,血管外科医生将需要更加努力工作以应对工作量。职业倦怠、执业模式变化、地理分布不均以及医疗保健覆盖范围和利用率的扩大,可能会对未来人力满足人口需求的能力产生不利影响。

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