University of Texas Health Houston School of Public Health, Department of Management, Policy and Community Health, Houston, Texas.
Akron Children's Hospital, Pediatric Hematology-Oncology, Akron, Ohio.
Pediatrics. 2024 Feb 1;153(Suppl 2). doi: 10.1542/peds.2023-063678L.
Pediatric hematology-oncology (PHO) is 1 of the oldest recognized pediatric subspecialities. PHO physicians care for infants, children, adolescents, and young adults with all types of cancer and nonmalignant blood conditions, in many cases temporarily assuming the role of a primary care physician because of the complexity and intensity of treatment. However, the number of clinically active PHO subspecialists needed to care for children in the United States remains unknown. Recent papers suggest a potential oversaturation of PHO physicians in some geographic areas. This article is part of a Pediatrics supplement focused on projecting the future supply of the pediatric subspecialty workforce. It draws on information available in the literature, data from the American Board of Pediatrics, and findings from a new microsimulation model estimating the future supply of pediatric subspecialists through 2040. The model predicts a workforce growth in PHO subspecialists of 66% by 2040. Alternative scenarios, including changes in clinical time and fellowship size, resulted in a difference in growth of ±18% from baseline. The model also forecasts significant geographic maldistribution. For example, the current workforce is concentrated in the Northeast Census region and the model predicts the New England Census division will have a 2.9-fold higher clinical workforce equivalent per 100 000 children aged 0 to 18 years than the Mountain Census division by 2040. These findings suggest potential opportunities to improve the PHO subspecialty workforce and the outcomes and experiences of its patient population through educational changes, practice initiatives, policy interventions, and dedicated research.
儿科血液学-肿瘤学（PHO）是最早被认可的儿科亚专科之一。PHO 医生负责照顾患有各种癌症和非恶性血液疾病的婴儿、儿童、青少年和年轻成年人，在许多情况下，由于治疗的复杂性和强度，他们暂时承担了初级保健医生的角色。然而，美国需要多少有临床经验的 PHO 亚专科医生来照顾儿童尚不清楚。最近的论文表明，在某些地理区域，PHO 医生可能存在过剩的情况。本文是儿科增刊的一部分，重点关注预测儿科亚专科劳动力的未来供应。它借鉴了文献中的信息、美国儿科学会委员会的数据以及一项新的微观模拟模型的结果，该模型通过 2040 年估计儿科亚专科医生的未来供应。该模型预测到 2040 年，PHO 亚专科医生的劳动力增长 66%。包括临床时间和奖学金规模变化在内的替代方案导致增长与基线相比差异±18%。该模型还预测了显著的地理分布不均。例如，目前的劳动力集中在东北部人口普查区，该模型预测到 2040 年，新英格兰人口普查区每 10 万名 0 至 18 岁儿童的临床劳动力当量将是山区人口普查区的 2.9 倍。这些发现表明，通过教育变革、实践举措、政策干预和专门研究，有可能改善 PHO 亚专科劳动力及其患者群体的结果和体验。
