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美国基层医疗劳动力增长:十年进展有限,及到2040年的预计需求

US Primary Care Workforce Growth: A Decade of Limited Progress, and Projected Needs Through 2040.

作者信息

Bazemore Andrew W, Petterson Stephen M, McCulloch Kade K

机构信息

Center for Professionalism and Value in Healthcare, 1016 16th St NW Suite 700, Washington, DC, 20036, USA.

American Board of Family Medicine, Lexington, KY, USA.

出版信息

J Gen Intern Med. 2025 Feb;40(2):339-346. doi: 10.1007/s11606-024-09121-x. Epub 2024 Oct 23.

Abstract

BACKGROUND

Despite efforts to mitigate a projected primary care physician (PCP) shortage required to meet an aging, growing, and increasingly insured population, shortages remain, compounded by the COVID-19 pandemic, growing inequity, and persistent underinvestment.

OBJECTIVE

We examined primary care workforce trends over the past decade and revisited projected primary care clinician workforce needs through the year 2040.

DESIGN AND PARTICIPANTS

Using data from the AMA Masterfile and Medical Expenditure Panel Survey (MEPS), we analyzed trends in the number of primary care physicians (PCPs) and in outpatient PCP visits by age and gender over the past decade. We then used the Medicare PECOS and Physician & Other Practitioners datasets to identify nurse practitioners (NPs) and physician assistants (PAs) in primary care.

MEASURES

Using these baseline clinician enumerations and projected population growth estimates from the US Census Bureau for the years 2020-2040, we calculated estimated primary care workforce needs by 2040.

KEY RESULTS

The effects of aging and population growth and baseline shortages in the primary care workforce call for significant increases in the primary care workforce to accommodate rising demands. Office visits to primary care clinicians are projected to increase from 773,606 in 2020 to 893,098 in 2040. We project a need for an additional 57,559 primary care clinicians by 2040.

CONCLUSIONS

Workforce shortages in primary care continue to expand due to population aging, growth, and heightened rates of clinician burnout & egress.

摘要

背景

尽管已努力缓解预计出现的初级保健医生短缺问题,以满足人口老龄化、增长且参保人数不断增加的需求,但短缺现象依然存在,新冠疫情、日益严重的不平等以及持续的投资不足更是雪上加霜。

目的

我们研究了过去十年初级保健劳动力的趋势,并重新审视了到2040年预计的初级保健临床医生劳动力需求。

设计与参与者

利用美国医学协会主文件和医疗支出面板调查(MEPS)的数据,我们分析了过去十年初级保健医生数量以及按年龄和性别划分的门诊初级保健医生就诊次数的趋势。然后,我们使用医疗保险PECOS和医生及其他从业者数据集来确定从事初级保健工作的执业护士(NP)和医师助理(PA)。

测量方法

利用这些基线临床医生计数以及美国人口普查局对2020 - 2040年的预计人口增长估计数,我们计算了到2040年预计的初级保健劳动力需求。

主要结果

老龄化、人口增长以及初级保健劳动力的基线短缺效应要求大幅增加初级保健劳动力,以满足不断增长的需求。预计到初级保健临床医生处的门诊就诊次数将从2020年的773,606次增加到2040年的893,098次。我们预计到2040年还需要额外57,559名初级保健临床医生。

结论

由于人口老龄化、增长以及临床医生职业倦怠和离职率上升,初级保健领域的劳动力短缺问题持续加剧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e344/11802952/96cf4f2ad67d/11606_2024_9121_Fig1_HTML.jpg

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