Hooker Roderick S, Curry Kim, Tracy Christine
Health Services Research, Retired, Portland, USA.
Nursing, University of Florida, Tampa, USA.
Cureus. 2024 Nov 7;16(11):e73216. doi: 10.7759/cureus.73216. eCollection 2024 Nov.
Introduction The utilization of physician associates (PAs) and nurse practitioners (NPs) within the United States healthcare system has increased substantially since their inception in the 1960s. While many PAs and NPs are educated and work within specialty areas in their clinical practice, the federal government does not identify PAs and NPs by specialty in its workforce projections. Methods We obtained data from publicly available sources as well as professional organizations. Employment status, specialty, and location information for NPs and PAs were drawn from association census surveys. Results Outpatient or ambulatory care employment sites employ 46.6% of NPs and 55.3% of PAs, while almost a quarter of each group (22.1% and 23.9%, respectively) work in general and surgical hospitals. About 9% of providers who are PAs and NPs are employed in Federally Qualified Health Centers, many of which are in health professional shortage areas (HPSAs). The number of PAs and NPs working in HPSAs has significantly increased from 72,000 PAs and NPs in 2011 to 110,000 in 2023. There has been no growth of physicians in HPSAs during this same time. The Health Resources and Services Administration (HRSA) does not identify NPs and PAs by their specialty practice area so the extent to which they provide care in specialty areas is unknown based on HRSA data. Conclusion It is essential to provide detailed information inclusive of PAs and NPs as well as physicians in planning for healthcare workforce needs. The accurate projection of potential healthcare provider shortages requires knowledge of each type of provider along with their role and specialization to determine gaps in healthcare service delivery.
引言 自20世纪60年代医生助理（PA）和执业护士（NP）在美国医疗系统中出现以来，其使用量大幅增加。虽然许多PA和NP在临床实践中接受教育并在专业领域工作，但联邦政府在其劳动力预测中并未按专业对PA和NP进行区分。方法 我们从公开可用来源以及专业组织获取数据。NP和PA的就业状况、专业和地点信息来自协会普查。结果 门诊或流动护理就业场所雇佣了46.6%的NP和55.3%的PA，而每组中近四分之一（分别为22.1%和23.9%）在综合医院和外科医院工作。约9%的PA和NP受雇于联邦合格健康中心，其中许多位于卫生专业人员短缺地区（HPSA）。在HPSA工作的PA和NP数量已从2011年的72,000名显著增加到2023年的110,000名。在此期间，HPSA的医生数量没有增长。卫生资源与服务管理局（HRSA）未按NP和PA的专业执业领域进行区分，因此根据HRSA数据，他们在专业领域提供护理的程度尚不清楚。结论 在规划医疗劳动力需求时，提供包括PA、NP以及医生的详细信息至关重要。准确预测潜在的医疗服务提供者短缺需要了解每种类型的提供者及其角色和专业，以确定医疗服务提供中的差距。
