National Study of the Emergency Physician Workforce, 2020

Bennett, Christopher L.; Sullivan, Ashley F.; Ginde, Adit A.; Rogers, John A.; Espinola, Janice A.; Clay, C; Camargo, Carlos A.

doi:10.1016/j.annemergmed.2020.06.039

Cited by 53 publications

(112 citation statements)

References 21 publications

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“…This is way below the international standards. (16) Deaths among healthcare workers involved in COVID-19 care in India stands at 665. (17) However, the mortality rates of HCWs in India are almost comparable that found in other parts of the world.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey

Gopinathan

Kunju

et al. 2021

Disaster med. public health prep.

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Objective: Emergency Medicine being a young specialty in India, we aimed to assess the level of disaster preparedness and planning strategies among various academic Emergency Departments (EDs) across India during the COVID-19 pandemic. Methods: A cross-sectional multicentric survey was developed and disseminated online to various academic EDs in India and followed up over a period of 8 weeks. All results were analysed using descriptive statistics. Results: 28 Academic Emergency Medicine Departments responded to the study. Compared to Pre-COVID period, COVID-19 pandemic has led to 90% of centres developing separate triage system with dedicated care areas for COVID suspect/infected in 78.6% centres with nearly 70% utilizing separate transportation pathways. Strategizing and executing the Institutional COVID-19 treatment protocol in 80% institutes were done by Emergency Physicians. Training exercises for airway management and PPE usage were seen in 93% and 80% centres respectively. Marked variation in recommended PPE usage were observed across EDs in India. Conclusions: Our study highlights the high variance in the level of preparedness response among various EDs across India during the pandemic. Preparedness for different EDs across India needs to be individually assessed and planned according to the needs and resources available.

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Section: Discussionmentioning

confidence: 99%

Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey

Gopinathan

Kunju

et al. 2021

Disaster med. public health prep.

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“…States with a higher percent rural population and those found in the Midwest and South had lower densities of EMBC EPs in 2017 and also had stagnant or worsening absolute shortages over time. Based on recent evidence that newly EM‐trained graduates predominantly practice in urban areas (96% for those less than 5 years out of training), 23 low EMBC EP densities in rural areas will remain an ongoing concern. The rural health landscape already faces documented challenges that are not unique to EM—rural hospitals serve communities that are, on average, lower income and older, experience more work‐related hazards, and are less mentally and physically healthy than communities served by urban hospitals 24 .…”

Section: Discussionmentioning

confidence: 99%

Supply and Demand of Emergency Medicine Board‐certified Emergency Physicians by U.S. State, 2017

Clay

Sullivan

Bennett

et al. 2020

Academic Emergency Medicine

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Objectives Our objective was to estimate the emergency medicine board‐certified emergency physician (EMBC EP) workforce supply and demand by U.S. state. Methods To estimate state demand, we applied the methodology from our 2005 analysis to calculate full‐time equivalent (FTE) EMBC EP demand for each emergency department (ED). The 2017 National Emergency Department Inventory–USA provided visit volumes for all EDs, while the American Board of Medical Specialties supplied the 2017 number of EMBC EPs per state. Assuming that at least one EMBC EP should be present 24/7 in each ED (requiring 5.35 FTEs minimum), we calculated the total FTEs required by dividing each ED’s visit volume by the estimated average visits seen by an EMBC EP (3,548 visits per year) and then summed FTEs by state. The U.S. Census Bureau provided state demographic characteristics. We used multivariable linear regression to examine the association between state demographics and the density of EMBC EPs per state and compared 2017 results to our prior 2005 analysis. Results There were 40,716 total EMBC EPs in 2017, fulfilling 77% of the estimated national demand. This was a substantial increase from 23,035 total EMBC EPs fulfilling 58% of demand in 2005. The 2017 supply ranged from 24% of demand in North Dakota to 142% in Hawaii. A lower density of EMBC EPs was associated with states in the Midwest and South (p < 0.001) and with a more rural population (p = 0.02). The absolute shortage of EMBC EPs worsened or remained the same in one‐fourth of states. Conclusion While the total number of EMBC EPs nearly doubled between 2005 and 2017, a shortage of full‐time coverage persists. The supply and demand vary greatly by state. Worsening absolute shortages in several states show that the distribution of EMBC EPs is not meeting demand across the United States, particularly in rural areas.

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“…Furthermore, solutions to EMS workforce shortages must focus on how to draw paramedic graduates, who may not have been trained locally, to seek employment and opportunities to serve in rural communities (32). There are examples of similar issues and approaches to the rural-urban dichotomies in accessing education and practice for other health professions, such as medicine and nursing (35,(38)(39)(40)(41)(42).…”

Section: Accepted Manuscript Discussionmentioning

confidence: 99%

Geographic Distribution of Accredited Paramedic Education Programs in the United States

Cash¹,

Clay²,

Leggio³

et al. 2021

Prehospital Emergency Care

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Background: The geographic distribution and access to paramedic education programs is unclear but often cited as a reason for emergency medical services (EMS) workforce shortages. Our aims were: 1) to examine the spatial distribution of accredited paramedic programs, and 2) to compare characteristics of communities with and without existing programs. Methods: We performed a cross-sectional study of US paramedic education programs accredited by the Commission on Accreditation of Allied Health Education Programs as of April 2020. Program locations were geocoded to county, and population estimates from the US Census Bureau were used to determine the adult population within the program's potential catchment area (30, 50, 100 miles). Clustering of programs was examined using Moran's I. We compared community characteristics obtained from the 2018 American Community Survey, 2018-2019 Area Health Resources Files, and 2018 National Emergency Department Inventory between counties with and without programs. Logistic regression models were used to determine associations of community characteristics and existence of a paramedic program, controlling for urbanicity. Results: There were 790 paramedic program locations in the US, located in 596/3142 (19%) counties. Every state, except Rhode Island and Washington, DC, had at least one paramedic program site. The population within potential catchment areas ranged from 182 million (30 miles) to 248 million (100 miles), representing 73% to 99% of the US adult population, respectively. However, among counties classified as rural (n=644), this decreased to 22% (30 miles) to 95% (100 miles). There was significant clustering of programs (p<0.001). There were significantly higher odds of having a paramedic program for counties classified as metro compared to non-metro (OR 4.42, 95% CI 3.60-5.42) and with the presence of healthcare resources (e.g., emergency department in the county: OR 2.42, 95% CI 1.87-3.14). Conclusions: Approximately 73% of the US adult population lives within 30 miles of an existing paramedic education program; however, this decreases to 22% in rural areas. Geographic barriers to accessing paramedic education remain a challenge for ongoing efforts to address the rural EMS workforce shortage.

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National Study of the Emergency Physician Workforce, 2020

Cited by 53 publications

References 21 publications

Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey

Assessment of the Preparedness and Planning of Academic Emergency Departments in India During the COVID-19 Pandemic: A Multicentric Survey

Supply and Demand of Emergency Medicine Board‐certified Emergency Physicians by U.S. State, 2017

Geographic Distribution of Accredited Paramedic Education Programs in the United States

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