End-of-life care at academic medical centers: implications for future workforce requirements.
The expansion of U.S. physician workforce training has been justified on the basis of population growth, technological innovation, and economic expansion. Our analyses found threefold differences in physician full-time-equivalent (FTE) inputs for Medicare cohorts cared for at academic medical centers (AMCs); AMC inputs were highly correlated with the number of physician FTEs per Medicare beneficiary in AMC regions. Given the apparent inefficiency of current physician practices, the supply pipeline is sufficient to meet future needs through 2020, with adoption of the workforce deployment patterns now seen among AMCs and regions dominated by large group practices.
Goodman
David C
DC
Center for the Evaluative Clinical Sciences (CECS), Dartmouth Medical School, Hanover, New Hampshire, USA. david.goodman@dartmouth.edu
Stukel
Thérèse A
TA
Chang
Chiang-hua
CH
Wennberg
John E
JE
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking / Q000379:methods*; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D017598:Efficiency, Organizational; D005544:Forecasting; D006302:Health Services Research; D006280:Health Workforce / Q000639:trends; D006801:Humans; D016345:Medicare Part B / Q000706:statistics & numerical data*; D020380:Needs Assessment; D010561:Personnel Staffing and Scheduling; D010820:Physicians / Q000600:supply & distribution*; D011157:Population Dynamics; D012040:Regional Health Planning; D013727:Terminal Care / Q000706:statistics & numerical data*; D014481:United States