Policy Changes Key To Promoting Sustainability And Growth Of The Specialty Palliative Care Workforce

被引：141

作者：

Kamal, Arif H. ^{[1
]}

Wolf, Steven P. ^{[2
]}

Troy, Jesse ^{[3
]}

Leff, Victoria ^{[4
]}

Dahlin, Constance ^{[5
]}

Rotella, Joseph D. ^{[6
]}

Handzo, George ^{[7
]}

Rodgers, Phillip E. ^{[8
]}

Myers, Evan R. ^{[9
]}

机构：

[1] Duke Canc Inst, Med, Durham, NC 27710 USA

[2] Duke Univ, Sch Med, Durham, NC USA

[3] Duke Univ, Sch Med, Dept Pediat, Durham, NC USA

[4] Duke Univ Hosp, Sect Palliat Care, Durham, NC USA

[5] Hosp & Palliat Nurses Assoc, Boston, MA USA

[6] Amer Acad Hosp & Palliat Med, Chicago, IL USA

[7] Healthcare Chaplaincy Network, Hlth Serv Res & Qual, New York, NY USA

[8] Univ Michigan, Med Sch, Family Med, Ann Arbor, MI 48109 USA

[9] Duke Univ, Sch Med, Obstet & Gynecol, Durham, NC USA

来源：

HEALTH AFFAIRS | 2019年 / 38卷 / 06期

基金：

美国医疗保健研究与质量局;

关键词：

SERIOUS ILLNESS; BURNOUT; ASSOCIATION; INTEGRATION; PATIENT; HOSPICE;

D O I：

10.1377/hlthaff.2019.00018

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Specialized palliative care teams improve outcomes for the steadily growing population of people living with serious illness. However, few studies have examined whether the specialty palliative care workforce can meet the growing demand for its services. We used 2018 clinician survey data to model risk factors associated with palliative care clinicians leaving the field early, and we then projected physician numbers from 2019 to 2059 under four scenarios. Our modeling revealed an impending "workforce valley," with declining physician numbers that will not recover to the current level until 2045, absent policy change. However, sustained growth in the number of fellowship positions over ten years could reverse the worsening workforce shortage. There is an immediate need for policies that support high-value, team-based palliative care through expansion in all segments of the specialty palliative care workforce, combined with payment reform to encourage the deployment of sustainable teams.

引用

页码：910 / 918

页数：9

共 27 条

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[Anonymous], PRIM CAR 1 MOD OPT

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