Supply and Demand of Board‐certified Emergency Physicians by U.S. State, 2005

Sullivan, Ashley F.; Ginde, Adit A.; Espinola, Janice A.; Camargo, Carlos A.

doi:10.1111/j.1553-2712.2009.00509.x

Cited by 13 publications

(19 citation statements)

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“…A similar table for physicians would contain more information but no more clarity, since most analyses of physician supply and requirements focus on particular specialty areas such as emergency care [ 107 ] or obstetrics [ 108 ] as opposed to the physician supply as a whole. As Fig.…”

Section: Discussionmentioning

confidence: 99%

A synthesis of recent analyses of human resources for health requirements and labour market dynamics in high-income OECD countries

et al. 2016

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BackgroundRecognition of the importance of effective human resources for health (HRH) planning is evident in efforts by the World Health Organization (WHO) and the Global Health Workforce Alliance (GHWA) to facilitate, with partner organizations, the development of a global HRH strategy for the period 2016–2030. As part of efforts to inform the development of this strategy, the aims of this study, the first of a pair, were (a) to conduct a rapid review of recent analyses of HRH requirements and labour market dynamics in high-income countries who are members of the Organisation for Economic Co-operation and Development (OECD) and (b) to identify a methodology to determine future HRH requirements for these countries.MethodsA systematic search of peer-reviewed literature, targeted website searches, and multi-stage reference mining were conducted. To supplement these efforts, an international Advisory Group provided additional potentially relevant documents. All documents were assessed against predefined inclusion criteria and reviewed using a standardized data extraction tool.ResultsIn total, 224 documents were included in the review. The HRH supply in the included countries is generally expected to grow, but it is not clear whether that growth will be adequate to meet health care system objectives in the future. Several recurring themes regarding factors of importance in HRH planning were evident across the documents reviewed, such as aging populations and health workforces as well as changes in disease patterns, models of care delivery, scopes of practice, and technologies in health care. However, the most common HRH planning approaches found through the review do not account for most of these factors.ConclusionsThe current evidence base on HRH labour markets in high-income OECD countries, although large and growing, does not provide a clear picture of the expected future HRH situation in these countries. Rather than HRH planning methods and analyses being guided by explicit HRH policy questions, most of the reviewed studies appeared to derive HRH policy questions based on predetermined planning methods. Informed by the findings of this review, a methodology to estimate future HRH requirements for these countries is described.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0155-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A synthesis of recent analyses of human resources for health requirements and labour market dynamics in high-income OECD countries

et al. 2016

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“…While an overall shortage of EPs has been described, 3–7 the shortage is greater in rural areas 4–7 . Discussions addressing rural ED staffing generally describe ED staffing needs without distinction to ED location or patient volume 19,20 .…”

Section: Discussionmentioning

confidence: 99%

“…While there is an overall shortage of emergency physicians (EPs; emergency medicine [EM] residency–trained/board‐certified physicians), 3–7 the shortage is accentuated in lower‐volume EDs and in rural areas 4–7 . Most lower‐volume EDs are in states with large rural areas 7,8 . Others have noted the challenge of staffing low‐volume EDs 7,9 .…”

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confidence: 99%

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Distribution of Emergency Departments According to Annual Visit Volume and Urban–Rural Status: Implications for Access and Staffing

Muelleman¹,

Sullivan²,

Espinola³

et al. 2010

Academic Emergency Medicine

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Objectives: Ongoing efforts to improve access to emergency care and emergency department (ED) staffing would benefit from a better understanding of the distribution of EDs in the United States by size and location. This article describes the distribution of U.S. ED visit volumes according to ED urban versus rural status. Methods:The authors used the 2007 National Emergency Department Inventories (NEDI)-USA database to identify all nonfederal U.S. hospitals with EDs and their annual ED visit volumes. One of twelve 2003 Urban Influence Codes was applied to each ED location based on its county. These categories were collapsed into urban counties and three types of rural counties: adjacent to urban, large nonadjacent, and small nonadjacent. The number of emergency physicians (EPs) needed to staff the higher-volume rural EDs was estimated.Results: Of the 4,874 U.S. EDs in 2007, 58% were in urban counties and 42% in rural counties. Among the 2,038 rural EDs, 56% were adjacent to urban, 15% were large nonadjacent, and 29% were small nonadjacent. Of the 1,503 lower-volume (< 10,000 visit) EDs, 21% were in urban counties. Of the 3,371 higher-volume ( ‡ 10,000 visit) EDs, 25% were in rural counties. Of the 857 higher-volume rural EDs, 66% were adjacent to urban, 22% were large nonadjacent, and 12% were small nonadjacent. The authors estimate that approximately 5,600 EPs are needed to staff these higher-volume rural EDs.Conclusions: There are many lower-volume EDs in urban areas and higher-volume EDs in rural areas. Most higher-volume rural EDs are in rural areas adjacent to urban counties. These data challenge popular assumptions regarding ED visit volumes, locations, and staffing needs.

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“…Categorization of emergency services in the United States has been a topic of debate for over 40 years and has been considered by the National Academy of Sciences National Research Council (1966), the American Medical Association (1971), the Joint Commission on the Accreditation of Healthcare Organizations (1994), and the Institute of Medicine (IOM; 2006) . In its 2006 three‐volume report on the state of emergency medicine in the United States, the IOM recommended the development of “evidence‐based categorization systems for emergency medical services, emergency departments, and trauma centers” and the promotion of “coordinated, regionalized, and accountable emergency care systems throughout the country.” These reports reenergized the dialogue around categorizing and organizing emergency care, resulting in the development of an Academic Emergency Medicine consensus conference supported by the federal government and multiple emergency care societies; the creation of the Emergency Care Coordination Center (ECCC) within the Department of Health & Human Services; and a policy research interest in understanding characteristics, workforce, and access to emergency care in the United States …”

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confidence: 99%

A Pilot Study Describing Access to Emergency Care in Two States Using a Model Emergency Care Categorization System

et al. 2013

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Objectives: The Institute of Medicine (IOM)'s "Future of Emergency Care" report recommended the categorization and regionalization of emergency care, but no uniform system to categorize hospital emergency care capabilities has been developed. The absence of such a system limits the ability to benchmark outcomes, to develop regional systems of care, and of patients to make informed decisions when seeking emergency care. The authors sought to pilot the deployment of an emergency care categorization system in two states.Methods: A five-tiered emergency department (ED) categorization system was designed, and a survey of all Pennsylvania and Wisconsin EDs was conducted. This 46-item survey described hospital staffing, characteristics, resources, and practice patterns. Based on responses, EDs were categorized as limited, basic, advanced, comprehensive, and pediatric critical care capable. Prehospital transport times were then used to determine population access to each level of care.Results: A total of 247 surveys were received from the two states (247 of 297, 83%). Of the facilities surveyed, roughly one-quarter of hospitals provided advanced care, 10.5% provided comprehensive care, and 1.6% provided pediatric critical care. Overall, 75.1% of the general population could reach an advanced or comprehensive ED within 60 minutes by ground transportation. Among the pediatric population (age 14 years and younger), 56.2% could reach a pediatric critical care or comprehensive ED, with another 19.5% being able to access an advanced ED within 60 minutes.Conclusions: Using this categorization system, fewer than half of all EDs provide advanced or comprehensive emergency care. While the majority of the population has access to advanced or comprehensive care within an hour, a significant portion (25%) does not. This article describes how an ED categorization scheme could be developed and deployed across the United States. There are implications for prehospital planning, patient decision-making, outcomes measurement, interfacility transfer coordination, and development of regional emergency care systems.ACADEMIC EMERGENCY MEDICINE 2013; 20:894-903

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Supply and Demand of Board‐certified Emergency Physicians by U.S. State, 2005

Cited by 13 publications

References 15 publications

A synthesis of recent analyses of human resources for health requirements and labour market dynamics in high-income OECD countries

A synthesis of recent analyses of human resources for health requirements and labour market dynamics in high-income OECD countries

Distribution of Emergency Departments According to Annual Visit Volume and Urban–Rural Status: Implications for Access and Staffing

A Pilot Study Describing Access to Emergency Care in Two States Using a Model Emergency Care Categorization System

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