Scientist, Sunnybrook Research Institute Holland Bone & Joint Program; Assistant Professor, University of Toronto, Institute of Health Policy, Management & Evaluation Toronto, ON; Scientist, ICES Toronto, ON.
Rheumatologist and Scientist, Research Institute of the McGill University Health Centre; Associate Professor, Department of Epidemiology, McGill University, Montreal, QC.
Healthc Policy. 2021 Feb;16(3):119-134. doi: 10.12927/hcpol.2021.26428.
Rheumatology workforces are increasingly challenged by too few physicians in face of the growing burden of rheumatic and musculoskeletal diseases (RMDs). Rheumatology is one of the most frequent non-surgical specialty referrals and has the longest wait times for subspecialists. We used a population-based approach to describe changes in the rheumatology workforce, patient volumes and geographic variation in the supply of and access to rheumatologists, in Ontario, Canada, between 2000 and 2019, and projected changes in supply by 2030. Over time, we observed greater feminization of the workforce and increasing age of workforce members. We identified a large regional variation in rheumatology supply. Fewer new patients are seen annually, which likely contributes to increasing wait times and reduced access to care. Strategies and policies to raise the critical mass and improve regional distribution of supply to effectively provide rheumatology care and support the healthcare delivery of patients with RMDs are needed.
风湿病工作队伍在面对不断增加的风湿和肌肉骨骼疾病（RMD）负担时，面临着医生数量太少的挑战。风湿病是最常见的非手术专科转诊之一，专科医生的候诊时间最长。我们采用基于人群的方法，描述了 2000 年至 2019 年期间加拿大安大略省风湿病工作队伍、患者数量以及风湿病医生供应和获得情况的地域差异的变化，并预测了 2030 年的供应变化。随着时间的推移，我们观察到劳动力队伍中女性化程度越来越高，劳动力成员的年龄也越来越大。我们发现风湿病供应存在很大的地区差异。每年看诊的新患者越来越少，这可能导致候诊时间延长，获得治疗的机会减少。需要采取策略和政策来提高供应的临界质量，并改善供应的区域分布，以有效地提供风湿病护理，并支持 RMD 患者的医疗服务提供。
