Davis K
Johns Hopkins Med J. 1982 Feb;150(2):55-64.
In the fall of 1980 the Graduate Medical Education National Advisory Committee (GMENAC) issued a report estimating that the supply of physicians will increase by 43% from 1978 to 1990, compared with an increase of 11% in the United States population. GMENAC estimated that this will lead to a surplus of 70,000 physicians by 1990, increasing to 145,000 by the turn of the century. Particularly marked surpluses are estimated to occur for nearly all surgical specialties, as well as most medical subspecialties. This paper attempts to estimate the impact of this increase in the supply of physicians on health care utilization and spending for health care services. Using cross-sectional data for 1978 this study estimates that an increased supply of physicians increases hospital admissions, lengths of hospital stays, costs per hospital day, physician fees for specialty services, and physician expenditures per capita. However, physician incomes appear to be lower in areas with more physicians. Projections to 1990 indicate that total health expenditures may be $50 billion higher as a result of the increase in physician supply. Real incomes of physicians, however, may be no greater than in 1978.
1980年秋,研究生医学教育全国咨询委员会(GMENAC)发布了一份报告,估计从1978年到1990年,医生供应量将增长43%,而美国人口仅增长11%。GMENAC估计,到1990年,这将导致医生过剩7万名,到世纪之交将增至14.5万名。预计几乎所有外科专科以及大多数医学亚专科都会出现特别明显的过剩。本文试图评估医生供应量的这种增长对医疗保健利用和医疗保健服务支出的影响。利用1978年的横断面数据,本研究估计,医生供应量的增加会导致住院人数增加、住院时间延长、每日住院费用增加、专科服务的医生费用增加以及人均医生支出增加。然而,在医生较多的地区,医生收入似乎较低。到1990年的预测表明,由于医生供应量的增加,医疗总支出可能会高出500亿美元。然而,医生的实际收入可能不会高于1978年。