Yao Nengliang, Mutter Justin B, Berry James D, Yamanaka Takashi, Mohess Denise T, Cornwell Thomas
Nengliang (Aaron) Yao (
Justin B. Mutter is section head of geriatric medicine at the University of Virginia School of Medicine and a fellow at the Institute for Advanced Studies in Culture, University of Virginia.
Health Aff (Millwood). 2021 Mar;40(3):478-486. doi: 10.1377/hlthaff.2020.00671.
Little is known about the characteristics of the workforce providing home-based medical care for traditional (fee-for-service) Medicare beneficiaries. We found that the number of participating home care providers in traditional Medicare increased from about 14,100 in 2012 to around 16,600 in 2016. Approximately 4,000 providers joined or reentered that workforce annually, and 3,000 stopped or paused participation. The number of home visits that most participants provided each year remained below 200. Only 0.7 percent of physicians in Medicare provided fifty or more home visits annually, with little change over the course of five years. In contrast, the number of home-visiting nurse practitioners almost doubled, and the average number of home visits they made increased each year. Despite generally low overall participation of traditional Medicare providers in home-based care, the workforce has seen modest but steady growth, driven primarily by increasing nurse practitioner participation. Additional stimuli may be necessary to ensure workforce adequacy and stability.
对于为传统(按服务收费)医疗保险受益人提供居家医疗服务的劳动力特征,我们了解甚少。我们发现,参与传统医疗保险居家护理服务的提供者数量从2012年的约14,100人增加到2016年的约16,600人。每年约有4,000名提供者加入或重新进入该劳动力队伍,3,000名停止或暂停参与。大多数参与者每年提供的家访次数仍低于200次。医疗保险中只有0.7%的医生每年进行50次或更多次家访,在五年期间变化不大。相比之下,家访执业护士的数量几乎翻了一番,且他们每年进行的家访平均次数有所增加。尽管传统医疗保险提供者总体上对居家护理的参与度普遍较低,但该劳动力队伍仍实现了适度且稳定的增长,主要驱动力是执业护士参与度的提高。可能需要更多激励措施来确保劳动力充足和稳定。