Modeling the Hepatology Workforce in the United States: A Predicted Critical Shortage.

Document Type

Article

Publication Date

6-17-2020

Publication Title

Hepatology (Baltimore, Md.)

Abstract

BACKGROUND & AIMS: Liver disease is prevalent in the United States, and as the population ages, an increasing number of patients are anticipated to present for care. The state of the current hepatology workforce and future demand for hepatology providers is not known. The aim of this study was to model future projections for hepatology workforce demand. Approach & Results A workforce study of hepatology providers in the U.S. was completed using primary and secondary data sources. An integrated workforce framework model was used that combined socio-economic factors that drive economic demand, epidemiological factors that drive need, and utilization rates of healthcare services. Supply and demand projections were calculated for adult and pediatric hepatology professionals. Sensitivity analyses were conducted to cover the feasible range of these assumptions. An electronic survey of AASLD members whose practice included 50% or more hepatology was conducted. In 2018 the adult and pediatric workforce included 7,296 and 824 hepatology providers, composed of hepatologists, gastroenterologists, and advanced practice providers whose practice was ≥50% hepatology. The modeling analysis projects that in 2023, 2028, 2033 there will be a shortage of 10%, 23%, and 35% adult hepatology providers, respectively, and 19%, 20%, and 16% pediatric hepatology providers, respectively. In sensitivity analyses, a shortage of hepatology providers is predicted even under optimistic assumptions. Among respondents to the survey the median age was higher among gastroenterologists and general hepatologists compared to transplant hepatologists. The most common category treated by transplant hepatologists was general hepatology.

CONCLUSIONS: There is an impending critical shortage of adult and pediatric hepatology providers. Strategies are needed to encourage clinicians to pursue hepatology, especially in areas outside of transplant centers.

Clinical Institute

Digestive Health

Department

Hepatology

Department

Gastroenterology

Department

Swedish Digestive Health Institute

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