American Board of Pediatrics, Chapel Hill, North Carolina.
Tufts University School of Medicine, Boston, Massachusetts.
Pediatrics. 2024 Feb 1;153(Suppl 2). doi: 10.1542/peds.2023-063678B.
This article opens a multi-article Pediatrics supplement that provides a rigorous analysis of the projected pediatric subspecialty workforce in the United States. Congenital variations, epigenetics, exposures, lifestyle, preventive care, and medical interventions from conception through young adulthood set the stage for health and wellbeing in adulthood. Although care provided by pediatric subspecialists is associated with better outcomes and lower costs compared with adult providers, the authors of recent articles in the lay and medical literature have questioned the capacity of pediatric subspecialists to meet children's health care needs. This article highlights that, despite numerous advances in prevention, diagnosis, and treatment, the last decade has witnessed increasing numbers of children with acute or chronic physical and mental health disorders, including medical complexity, obesity, type 2 diabetes, anxiety, depression, and suicidality, all of which are exacerbated by poverty, racism, and other social drivers of health. In this article, we then describe the variability in the demographics, practice characteristics, and geographic distribution of the 15 core pediatric subspecialties certified by the American Board of Pediatrics. We then discuss the rationale and approach to the development of a pediatric subspecialty workforce model that forecasts subspecialist supply from 2020 to 2040 for 14 subspecialties at the national and subnational levels (not including the newest subspecialty, pediatric hospital medicine), accounting for US Census Bureau child population projections. The model does not account for the unique physical and mental needs of individual children, nor does it address the increasingly precarious commitment to, and financing of, pediatric subspecialty care in the US health care system impacting market demand.
本文开启了一个多文章儿科增刊，对美国儿科亚专业劳动力的预计情况进行了严格分析。从受孕到青年期的先天变异、表观遗传学、暴露、生活方式、预防保健和医疗干预为成年期的健康和福祉奠定了基础。尽管与成人提供者相比，儿科专家提供的护理与更好的结果和更低的成本相关，但在通俗和医学文献中的近期文章的作者对儿科专家是否有能力满足儿童的医疗保健需求提出了质疑。本文强调，尽管在预防、诊断和治疗方面取得了许多进展，但在过去十年中，患有急性或慢性身心健康障碍的儿童人数不断增加，包括医疗复杂性、肥胖症、2 型糖尿病、焦虑、抑郁和自杀倾向，所有这些都因贫困、种族主义和其他健康社会驱动因素而加剧。在本文中，我们随后描述了 15 个核心儿科亚专业的认证情况，包括人口统计学、实践特征和地理分布。然后，我们讨论了制定儿科亚专业劳动力模型的理由和方法，该模型预测了 14 个亚专业在全国和次国家层面（不包括最新的儿科医院医学亚专业）从 2020 年到 2040 年的亚专业供应情况，考虑了美国人口普查局儿童人口预测。该模型不考虑个别儿童的独特身心需求，也不解决美国医疗保健系统中影响市场需求的儿科亚专业护理日益不稳定的承诺和融资问题。
