Qiu Abram, Meadows Kristopher, Ye Fei, Iyawe Osasu, Kenneth-Nwosa Kenneth
Department of Orthopaedics, University of Texas Health Science Center, San Antonio, TX, United States.
Online J Public Health Inform. 2025 Jan 31;17:e63560. doi: 10.2196/63560.
There is a growing gap between the supply of surgeons and the demand for orthopedic services in the United States.
We analyzed publicly available online data to assess the correlation between the supply of orthopedic surgeons and patient demand across the United States. The geographic trends of this gap were assessed by using the relative demand index (RDI) to guide precision public health interventions such as resource allocation, residency program expansion, and workforce planning to specific regions.
The data used were from the US Census Bureau, Association of American Medical Colleges (AAMC) through their 2024 Electronic Residency Application Service (ERAS) directory, AAMC State Physician Workforce Data Report, and Google Trends. We calculated the normalized relative search volume (RSV) and the RDI and compared them to the densities of orthopedic surgeons across the United States. We examined the disparities with the Spearman rank correlation coefficient.
The supply of orthopedic surgeons varied greatly across the United States, with a significantly higher demand for them in southern states (P=.02). The orthopedic surgeon concentration, normalized to the highest density, was the highest in Alaska (n=100), the District of Columbia (n=96), and Wyoming (n=72); and the lowest in Texas (n=0), Arkansas (n=6), and Oklahoma (n=64). The highest RDI values were observed in Utah (n=97), Florida (n=88), and Texas (n=83), while the lowest were observed in Alaska (n=0), the District of Columbia (n=5), and New Hampshire (n=7). The 7 states of Alaska, Maine, South Dakota, Wyoming, Montana, Delaware, and Idaho lacked orthopedic surgery residencies. In 2023, New York (n=19), Michigan (n=17), Ohio (n=17), Pennsylvania (n=16), and California (n=16) had the most residency programs. Demand and supply, represented by the RDI and orthopedic surgeon concentration, respectively, were strongly correlated negatively (ρ=-0.791, P<.001). States that were in the top quartile of residency programs (≥4 residency programs) exhibited a high demand for orthopedic surgeons (ρ=.6035, P=.02).
This study showed that regional disparities in access to orthopedic care can be addressed by increasing orthopedic residencies. The study highlights the novel application of the RDI to mapping the regional need for orthopedics, and this map allows for better targeted resource allocation to expand orthopedic surgery training.
在美国，外科医生的供应与骨科服务需求之间的差距日益扩大。
我们分析了公开可用的在线数据，以评估美国骨科外科医生供应与患者需求之间的相关性。通过使用相对需求指数（RDI）来评估这种差距的地理趋势，以指导精准公共卫生干预措施，如资源分配、住院医师培训项目扩展以及针对特定地区的劳动力规划。
使用的数据来自美国人口普查局、美国医学院协会（AAMC）通过其2024年电子住院医师申请服务（ERAS）目录、AAMC州医师劳动力数据报告以及谷歌趋势。我们计算了标准化相对搜索量（RSV）和RDI，并将它们与美国各地骨科外科医生的密度进行比较。我们用斯皮尔曼等级相关系数检验差异。
美国各地骨科外科医生的供应差异很大，南部各州对他们的需求明显更高（P = 0.02）。以最高密度进行标准化后的骨科外科医生集中度，在阿拉斯加（n = 100）、哥伦比亚特区（n = 96）和怀俄明州（n = 72）最高；在得克萨斯州（n = 0）、阿肯色州（n = 6）和俄克拉何马州（n = 64）最低。在犹他州（n = 97）、佛罗里达州（n = 88）和得克萨斯州（n = 83）观察到最高的RDI值，而在阿拉斯加（n = 0）、哥伦比亚特区（n = 5）和新罕布什尔州（n = 7）观察到最低值。阿拉斯加、缅因州、南达科他州、怀俄明州、蒙大拿州、特拉华州和爱达荷州这7个州没有骨科手术住院医师培训项目。2023年，纽约州（n = 19）、密歇根州（n = 17）、俄亥俄州（n = 17）、宾夕法尼亚州（n = 16）和加利福尼亚州（n = 16）拥有最多的住院医师培训项目。分别由RDI和骨科外科医生集中度代表的需求和供应呈强烈负相关（ρ = -0.791，P < 0.001）。住院医师培训项目处于前四分位数（≥4个住院医师培训项目）的州对骨科外科医生的需求较高（ρ = 0.6035，P = 0.02）。
本研究表明，通过增加骨科住院医师培训项目可以解决骨科护理可及性的地区差异。该研究突出了RDI在绘制骨科区域需求方面的新应用，这张地图有助于更有针对性地分配资源以扩大骨科手术培训。
