兰德-The-Anesthesiologist-Workforce-in-2013_-A-Final-Briefing-to-the-American-Society-of-Anesthesiologists_102页_2mb

2013 Anesthesiologist Workforce Summary

Core Content

This report, prepared by the RAND Corporation for the American Society of Anesthesiologists (ASA), analyzes the anesthesiologist workforce in 2013. It follows up on a 2007 study that identified a potential shortage of anesthesiologists and nurse anesthetists, and explores how demographic and health care changes have affected the workforce over the years.

Main Findings

• Workforce Trends: The anesthesiologist workforce has seen a shift in demographics, with a growing proportion of women and an aging population.
• Regional Variations: There are significant regional differences in anesthesiologist practice patterns, with Western states showing distinct characteristics compared to other regions.
• Employment Arrangements: Anesthesiologists are more likely to work in single facilities in 2013 than in 2007, with the largest increase observed in the West.
• Team Care: Western anesthesiologists are more likely to work independently and less likely to collaborate with non-anesthesia providers.
• Shortage Analysis: While a national shortage was not observed in 2013, regional shortages, particularly in the South and Midwest, persisted.
• Econometric Model: The study used a maximum-likelihood approach to assess market equilibrium, showing a decrease in shortage from 2007 to 2013.
• Projections: The anesthesiologist supply is expected to peak in 2017 and then decline, with potential small shortages beginning that year. Certain scenarios could lead to either greater shortages or surpluses.
• Future Research: The report highlights areas for further research, including the impact of team care on the workforce and the role of gender in employment patterns.

Key Information

Demographics

• Age: The average age of anesthesiologists increased slightly from 2007 to 2013.
• Gender: There was a substantial increase in the proportion of female anesthesiologists, especially among the youngest and oldest age groups.
• Geographic Distribution: Regional differences in practice patterns were observed, with Western anesthesiologists more likely to work independently and in larger facilities.

Employment and Practice

• Employment Arrangements: In 2013, 47% of anesthesiologists worked in single facilities, up from 44% in 2007.
• Facility Size: Anesthesiologists are working in larger facilities, as measured by the number of providers.
• Team Care: There is a notable difference in team care participation across regions, with Western anesthesiologists being less involved in team-based care.

Shortage and Supply

• Shortage Trends: A national shortage observed in 2007 had largely disappeared by 2013, but regional shortages remained.
• Shortage Areas: The South and Midwest were identified as areas with higher levels of shortage.
• Supply Projections: The supply of anesthesiologists is projected to peak in 2017 and then decrease, leading to small shortages.

Methodology

• Survey Data: A national survey of ASA members was conducted in April-May 2013, with a 25.5% response rate.
• Data Sources: The study used the Area Health Resource File (AHRF) and National Resident Matching Program (NRMP) data to supplement survey findings.
• Weighting and Scaling: The data were weighted to account for non-response and scaled to reflect the total number of anesthesiologists in the U.S.

Research Implications

• Workforce Changes: The increasing proportion of women in the workforce may lead to changes in employment arrangements and patient focus.
• Market Equilibrium: The study suggests the national labor market for anesthesiologists is near equilibrium, but confidence intervals are large, indicating the need for more granular data.
• Future Scenarios: The report outlines potential scenarios that could lead to greater shortages or surpluses, including changes in health care delivery and policy.

Conclusion

The 2013 study provides updated insights into the anesthesiologist workforce, highlighting the shift in demographics, regional practice differences, and the evolving landscape of health care. While the national shortage appears to have diminished, regional disparities and the potential for future shortages remain areas of concern. The report underscores the importance of continued research and data collection to better understand and manage these trends.