Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina.
Pediatrics. 2024 Feb 1;153(Suppl 2). doi: 10.1542/peds.2023-063678C.
Concerns persist about whether the United States has an adequate supply of pediatric subspecialists and whether they are appropriately distributed across the nation to meet children's health needs. This article describes the data and methods used to develop a workforce projection model that estimates the future supply of 14 pediatric subspecialities certified by the American Board of Pediatrics at the national and US census region and division levels from 2020 to 2040. The 14 subspecialties include adolescent medicine, pediatric cardiology, child abuse pediatrics, pediatric critical care medicine, developmental-behavioral pediatrics, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology-oncology, pediatric infectious diseases, neonatal-perinatal medicine, pediatric nephrology, pediatric pulmonology, and pediatric rheumatology. Hospital medicine was excluded because of the lack of historical data needed for the model. This study addresses the limitations of prior models that grouped adult and pediatric physician subspecialty workforces together and aggregated pediatric subspecialties. The model projects supply at national and subnational levels while accounting for geographic moves that pediatric subspecialists make after training and during their career. Ten "what if" scenarios included in the model simulate the effect of changes in the number of fellows entering training, the rate at which subspecialists leave the workforce, and changes in hours worked in direct and indirect clinical care. All model projections and scenarios are available on a public, interactive Web site. The model's projections can also be examined with other data to provide insight into the possible future of the pediatric subspecialty workforce and offer data to inform decision-making.
人们仍然担心美国是否有足够的儿科亚专科医生供应，以及他们是否在全国范围内得到适当分布，以满足儿童的健康需求。本文介绍了用于开发劳动力预测模型的数据和方法，该模型估计了从 2020 年到 2040 年，在全国和美国人口普查区和分部级别，由美国儿科学会认证的 14 个儿科亚专科的未来供应情况。这 14 个亚专科包括青少年医学、儿科心脏病学、儿童虐待儿科学、儿科危重病医学、发育行为儿科学、儿科急诊医学、儿科内分泌学、儿科胃肠病学、儿科血液学-肿瘤学、儿科传染病学、新生儿围产期医学、儿科肾脏病学、儿科肺病学和儿科风湿病学。由于模型需要的历史数据缺乏，医院医学被排除在外。本研究解决了先前模型的局限性，这些模型将成人和儿科医生的亚专科劳动力混为一谈，并对儿科亚专科进行了汇总。该模型在考虑到儿科亚专科医生在培训后和职业生涯中进行地理转移的情况下，在国家和次国家层面预测供应情况。模型中包含的十个“假设”情景模拟了进入培训的研究员人数、离开劳动力的亚专科医生的比例以及直接和间接临床护理工作时间变化的影响。所有模型预测和情景都可以在一个公共的互动网站上获得。还可以使用其他数据来检查模型的预测，以深入了解儿科亚专科劳动力的未来，并提供数据来为决策提供信息。
