Street Maria Elisabeth, Di Sessa Anna, Esposito Andrea, Ibba Anastasia, Pepe Giorgia, Bonfanti Riccardo, Citriniti Felice, D'Annunzio Giuseppe, Licenziati Maria Rosaria, Wasniewska Malgorzata, Cherubini Valentino, Salerno Mariacarolina
Department of Medicine and Surgery, University of Parma, Via Gramsci 14, Parma, 43126, Italy.
Unit of Pediatrics, University Hospital of Parma, Parma, Italy.
Ital J Pediatr. 2025 Mar 24;51(1):90. doi: 10.1186/s13052-025-01940-w.
Pediatric endocrinology has developed enormously over the last 30 years. Many conditions followed-up are rare and/or chronic complex diseases requiring a high level of expertise. Therefore, defining pediatric endocrinology workforce has become crucial. We aimed to provide an overview of the landscape of the Italian Pediatric Endocrinology centers.
A national electronic survey on clinical endocrine practice among the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) centers was carried out. The full time equivalent (FTE) was used to assess the time dedicated by healthcare providers (HCPs) to pediatric endocrinology and calculate the needs.
Ninety-one centers completed the electronic survey. Forty-four/91 centers had incorporated a pediatric diabetology service, while the remaining had an independent center. Among HCPs, 271 were pediatric endocrinologists (94 with a temporary, and 265 with a permanent contract). In 14/91 centers, adult endocrinologists were part of the medical staff. In 45/91 centers clinical activity was carried out five days a week. A mean FTE of 0.56 for medical doctors, 0.49 for nurses, 0.31 for dietitians, and 0.13 for psychologists was reported. An average of 110 patients with rare diseases was followed per centre per year. Based on the ISPAD international criteria for the FTE required for the care of diabetic youths we considered rare diseases as a reference instead of diabetes, without considering any other consultations, and this showed a shortage of 80% of required pediatric endocrinologists, 89% of needed nurses, 93% of required dietitians, and 94% of required psychologists. Moreover, approximately 20 pediatric endocrinologists were expected to retire within the following two years. Overall, a mean of 1148 consultations/year per centre was reported for each medical FTE (a mean of 367 first consultations, and 786 follow-ups). Education and training for growth hormone and other specific treatments were provided by a variety of HCPs, mainly by medical doctors (22/91 centers).
At present pediatric endocrinology shows a significant burden of activity with a severe shortage of personnel. This should be addressed by policy makers in order to develop strategic programs to ensure optimal care. Recognizing pediatric endocrinology as a subspecialty and offering appropriate training programs would represent a significant step further.
在过去30年里，儿科内分泌学取得了巨大发展。许多随访的病症都是罕见病和/或慢性复杂疾病，需要高水平的专业知识。因此，明确儿科内分泌学专业人员构成变得至关重要。我们旨在概述意大利儿科内分泌学中心的情况。
对意大利儿科内分泌学与糖尿病学会（ISPED）各中心的临床内分泌实践开展了一项全国性电子调查。全职等效值（FTE）用于评估医疗服务提供者（HCP）投入到儿科内分泌学的时间并计算需求。
91个中心完成了电子调查。44/91个中心设有儿科糖尿病服务，其余为独立中心。在HCP中，有271名儿科内分泌学家（94名临时合同，265名永久合同）。14/91个中心有成人内分泌学家作为医务人员的一部分。45/91个中心每周开展5天临床活动。报告的医生平均全职等效值为0.56，护士为0.49，营养师为0.31，心理学家为0.13。每个中心每年平均随访110名罕见病患者。基于国际儿科糖尿病协会（ISPAD）关于糖尿病青少年护理所需全职等效值的标准，我们将罕见病作为参考而非糖尿病，且不考虑任何其他会诊情况，结果显示所需儿科内分泌学家短缺80%，所需护士短缺89%，所需营养师短缺93%，所需心理学家短缺94%。此外，预计在接下来的两年内约有20名儿科内分泌学家退休。总体而言，每个医疗全职等效值每年每个中心平均报告1148次会诊（首次会诊平均367次，随访786次）。生长激素及其他特定治疗的教育和培训由各类HCP提供，主要是医生（22/91个中心）。
目前儿科内分泌学的活动负担很重，人员严重短缺。政策制定者应解决这一问题，以制定战略计划确保提供最佳护理。将儿科内分泌学确认为一个亚专业并提供适当的培训计划将是重要的进一步举措。
