title: Projections of Demand for Cardiovascular Surgery and Supply of Surgeons.
abstract: BACKGROUND
  While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea.
  
  
  METHODS
  After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected.
  
  
  RESULTS
  The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario.
  
  
  CONCLUSIONS
  Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.
authors.affiliation: Department of Preventive Medicine, Keimyung University School of Medicine.
authors.forename: Jung Jeung
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine.
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Park
authors.affiliation: Department of Preventive Medicine, Konkuk University School of Medicine.
authors.forename: Kun Sei
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine.
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine.
authors.forename: Sung Bo
authors.initials: SB
authors.lastname: Sim
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Myo Jeong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Ji Suk
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Myunghwa
authors.initials: M
authors.lastname: Kim
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Choon Seon
authors.initials: CS
authors.lastname: Park
keywords: Economics, medical; Health policy; Health services needs and demand; Thoracic surgery