Workforce demographics and unit structure in paediatric cardiac critical care in the United States

2021 ◽  
pp. 1-5
Author(s):  
Robin V. Horak ◽  
Shasha Bai ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Heart Surgery ◽  
Age Groups ◽  
The United States ◽  
Work Hours ◽  
Full Time ◽  
Full Time Equivalent ◽  
Unit Structure ◽  
Cardiac Critical Care

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

scholarly journals Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017

2019 ◽  
Vol 134 (4) ◽  
pp. 386-394
Author(s):  
Meghan D. McGinty ◽  
Nancy Binkin ◽  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Chrissie Juliano
Keyword(s):  
Public Health ◽  
United States ◽  
Urban Health ◽  
The United States ◽  
Health Problems ◽  
Full Time ◽  
Health Departments ◽  
Public Health Services ◽  
Full Time Equivalent ◽  
Workforce Capacity

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments. Methods: BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies. Results: The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research. Conclusions: Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.

Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States

2021 ◽  
pp. 1-6
Author(s):  
Robin V. Horak ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
John M. Costello ◽  
...  
Keyword(s):  
Critical Care ◽  
Heart Surgery ◽  
Census Data ◽  
Predictive Modelling ◽  
The United States ◽  
Critical Care Medicine ◽  
Advanced Training ◽  
Training Programmes ◽  
Workforce Needs ◽  
Cardiac Critical Care

Abstract Objective: To assess the training and the future workforce needs of paediatric cardiac critical care faculty. Design: REDCap surveys were sent May−August 2019 to medical directors and faculty at the 120 US centres participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database. Faculty and directors were asked about personal training pathway and planned employment changes. Directors were additionally asked for current faculty numbers, expected job openings, presence of training programmes, and numbers of trainees. Predictive modelling of the workforce was performed using respondents’ data. Patient volume was projected from US Census data and compared to projected provider availability. Measurements and main results: Sixty-six per cent (79/120) of directors and 62% (294/477) of contacted faculty responded. Most respondents had training that incorporated critical care medicine with the majority completing training beyond categorical fellowship. Younger respondents and those in dedicated cardiac ICUs were more significantly likely to have advanced training or dual fellowships in cardiology and critical care medicine. An estimated 49–63 faculty enter the workforce annually from various training pathways. Based on modelling, these faculty will likely fill current and projected open positions over the next 5 years. Conclusions: Paediatric cardiac critical care training has evolved, such that the majority of faculty now have dual fellowship or advanced training. The projected number of incoming faculty will likely fill open positions within the next 5 years. Institutions with existing or anticipated training programmes should be cognisant of these data and prepare graduates for an increasingly competitive market.

Employment Opportunities for Pediatric Critical Care Fellowship Trained Physicians in the United States

2020 ◽  
Author(s):  
Abdallah R. Dalabih ◽  
Parthak Prodhan ◽  
Zena L. Harris ◽  
Meredith F. Bone
Keyword(s):  
United States ◽  
Critical Care ◽  
Training Programs ◽  
The United States ◽  
Full Time ◽  
Market Demand ◽  
Employment Opportunities ◽  
Pediatric Critical Care ◽  
Time Period ◽  
Full Time Employment

AbstractPediatric Critical Care Medicine (PCCM) training programs and trained fellows in the United State increased steadily without a corresponding increase in population growth. PCCM trainees worry about limited employment prospects. This study aimed to quantify the demand for PCCM trained physicians in the United States by prospectively tracking full-time employment opportunities over 12 months. The number of advertised opportunities identified was low compared with number of fellows likely to be seeking jobs during same time period. If market demand remains stable, there is risk of excess supply if number of newly fellowship-trained PCCM physicians continues to rise.

Status of the medical oncology workforce. The American Society of Clinical Oncology.

1996 ◽  
Vol 14 (9) ◽  
pp. 2612-2621 ◽  
Keyword(s):  
United States ◽  
Primary Care ◽  
Patient Care ◽  
Clinical Oncology ◽  
Medical Oncology ◽  
The United States ◽  
Full Time ◽  
Full Time Equivalent ◽  
Medical Oncologists ◽  
American Society

PURPOSE A survey was designed to determine accurately the number of full-time equivalent medical oncologists in the United States, to determine how medical oncologists in different work settings divide their professional activities, and to determine whether medical oncology represents a primary care specialty in the minds of practicing oncologists. METHODS A questionnaire was mailed to the 4,239 members of the American Society of Clinical Oncology (ASCO) who identified themselves as medical oncologists or hematologists/oncologists and were current residents of the United States. Follow-up letters, which included a second copy of the questionnaire, were sent to nonresponders. A third mailing, followed by a telephone reminder, was sent to a randomly selected subset of 300 nonresponders to be certain that the initial responders were similar in practice patterns and attitudes to those individuals who had not initially completed the survey. RESULTS A total of 2,540 physicians responded to the first mailing and an additional 187 to the second (64% response rate); a further 196 individuals who were directly contacted completed the survey document. Practitioners appear to see 160 to 200 different patients per month and to devote approximately 72% of their time to patient care activities. Research and teaching comprised only 3% to 4% of professional time for physicians in private practice or Health Maintenance Organization (HMO) settings, in contrast to 16% for those who worked in community hospitals. Medical oncologists frequently serve the role of principal care giver while patients are undergoing cancer treatment. However, medical oncologists devote minimal time providing primary care services to patients and, if required to increase their clinical volume, would prefer to care for more cancer patients than enhance their primary care activities. It is estimated that the present full-time equivalent number (ie, the conglomorate number of oncologists based on 100% professional effort devoted to clinical care) of medical oncologists is approximately 3,600 individuals. This translates into 1.8 medical oncologists per 100,000 adult Americans. CONCLUSION The medical oncology community devotes the majority of its time to providing oncologic patient care and does not provide or appear to wish to provide what the public defines as primary care. The survey estimate of 1.8 medical oncologists per 100,000 adult Americans is in close accord with HMO estimates of the number of desired oncologists. Consequently, the supply appears consistent with the anticipated demand. There does not appear to be an oversupply of medical oncologists in the United States.

Six-Year Trends in Productivity and Utilization of 73 Clinical Laboratories

2001 ◽  
Vol 125 (9) ◽  
pp. 1153-1161 ◽  
Author(s):  
Paul N. Valenstein ◽  
Amy H. Praestgaard ◽  
Ronald B. Lepoff
Keyword(s):  
United States ◽  
Labor Productivity ◽  
The United States ◽  
Reference Laboratory ◽  
Full Time ◽  
Full Time Equivalent ◽  
Activity Data ◽  
Test Volume ◽  
Clinical Laboratories ◽  
Annual Decline

Abstract Objectives.—To describe longitudinal trends in the efficiency, labor productivity, and utilization of clinical laboratories in the United States. Methods.—Financial and activity data were prospectively collected from 73 clinical laboratories continuously enrolled in the College of American Pathologists Laboratory Management Index Program from 1994 through 1999. Each laboratory reported quarterly on its costs, labor inputs, and test activity using uniform data definitions. Results.—During the 6-year study period, there was a significant increase in laboratory labor productivity (2.1% more tests/full-time equivalent/y; P &lt; .001). Productivity increases were offset by increasing labor expense (1.5%/full-time equivalent/y; P &lt; .001), consumable expense (1.7%/on-site test/y; P = .005), and blood expense, which comprised more than 10% of laboratory expenses by 1999 (4.4% increase/y; P &lt; .001). As a result, overall expense per test showed no significant change in non–inflation-adjusted dollars. Reference laboratory expense per test did not change significantly during the study period; the proportion of tests sent to reference laboratories grew slightly (0.06% increase/y; P &lt; .001). Test volume of the median laboratory grew by 5442 tests per year (2.3% annual increase; P &lt; .001), while the proportion of testing from inpatients declined by 1.7% per year (P &lt; .001). Inpatient test utilization declined on a discharge basis (annual decline of 1.2 tests/inpatient discharge; P &lt; .001) and on a per diem basis (annual decline of 0.08 tests/inpatient day; P = .002). Inpatient laboratory expense declined on a discharge basis (annual decline of $2.40 or 1.3% per discharge; P &lt; .001), but did not change significantly per inpatient day. Most of the reduction in the expense per discharge occurred during 1994–1996. Conclusions.—Between 1994 and 1999, clinical laboratories in the United States experienced significant changes in the cost of operations, utilization, and labor productivity. Laboratory administrators who compare local institutional performance with that of peers are advised to use current or forward-trended peer data. Quarter-to-quarter improvement in many measures of laboratory financial activity may not signal a superior operation, as performance of the whole industry appears to be improving.

scholarly journals Wine market in the United States and in the California

2005 ◽  
Vol 53 (6) ◽  
pp. 215-224
Author(s):  
Helena Chládková
Keyword(s):  
United States ◽  
The United States ◽  
Wine Industry ◽  
Full Time ◽  
Full Time Equivalent ◽  
Wine Production ◽  
The Czech Republic ◽  
Wine Consumption ◽  
Wine Market ◽  
Further Development

The paper describes wine market in the United States and in the California. The paper is focused on characteristic of winegrowing, wine-production, wine-consumption and wine export too. Export of California wine is growing and wine is exported to the EU for the first. We can expect to grow of interest of our consumers too. California wine will compete in high quality and low prices. California is the fourth largest wine producer in the world after France, Italy and Spain. It accounted for $ 643 million in wine exports in 2003 from $ 537 million in 1998. Wine grapes were grown in 46 of California’s 58 counties, covering 529000 acres in 2003. California produced 444 million gallons of wine in 1998 it is 90 percent of all U.S. wine production, making California the leading wine producing state in America. The California wine industry has an annual impact of $ 45.4 billion on the state’s economy. An important California employer, the wine industry provides 207550 full-time equivalent jobs in wineries, vineyards or other affiliated businesses throughout the state. There are at least 1294 bricks and mortar commercial wineries in California. But the wine consumption is very low in California.Because California together with South Africa and another countries that so-called New World are important producers with growing export, is very necessary to analyse these markets because they are great competitors for Czech producers. These problems solved in another foreigner markets Černíková, Žufan (2004), Duda (2004), Hrabalová (2004), Kudová (2005), Lišková (2004), Tomšík, Chládková (2005).The paper is a part of solution of the grant focused on analysis and formulation of further development of winegrowing and wine-production in the Czech Republic provided by the Ministry of Agriculture (No. QF 3276), and it is also a part of solution of the research plan of the Faculty of Business and Economics, MUAF in Brno (No. MSM 6215648904).

scholarly journals Incidence of Benign Meningiomas in the United States: Current and Future Trends

2021 ◽  
Author(s):  
Sonia Bhala ◽  
Douglas R Stewart ◽  
Victoria Kennerley ◽  
Valentina I Petkov ◽  
Philip S Rosenberg ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Cancer Registries ◽  
Health Impact ◽  
The United States ◽  
Birth Cohorts ◽  
Benign Meningioma ◽  
Case Count ◽  
Future Burden ◽  
Rate Ratios

Abstract Background Benign meningiomas are the most frequently reported central nervous system tumors in the United States (US), with increasing incidence in past decades. However, the future trajectory of this neoplasm remains unclear. Methods We analyzed benign meningioma incidence of cases identified by any means (eg, radiographically with or without microscopic confirmation) in US Surveillance Epidemiology and End Results (SEER) cancer registries among 35–84-year-olds during 2004–2017 by sex and race/ethnicity using age-period-cohort (APC) models. We employed APC forecasting models to glean insights regarding the etiology, distribution, and anticipated future (2018–2027) public health impact of this neoplasm. Results In all groups, meningioma incidence overall increased through 2010, then stabilized. Temporal declines were statistically significant overall and in most groups. JoinPoint analysis of cohort rate-ratios identified substantial acceleration in White men born after 1963 (from 1.1% to 3.2% per birth year); cohort rate-ratios were stable or increasing in all groups and all birth cohorts. We forecast that meningioma incidence through 2027 will remain stable or decrease among 55–84-year-olds but remain similar to current levels among 35–54-year-olds. Total meningioma burden in 2027 is expected to be approximately 30,470 cases, similar to the expected case count of 27,830 in 2018. Conclusions Between 2004–2017, overall incidence of benign meningioma increased and then stabilized or declined. For 2018–2027, our forecast is incidence will remain generally stable in younger age groups but decrease in older age groups. Nonetheless, the total future burden will remain similar to current levels because the population is aging.

A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States

2021 ◽  
pp. 003335492110181
Author(s):  
Richard J. Martino ◽  
Kristen D. Krause ◽  
Marybec Griffin ◽  
Caleb LoSchiavo ◽  
Camilla Comer-Carruthers ◽  
...  
Keyword(s):  
United States ◽  
Gay Men ◽  
Antibody Test ◽  
Nationwide Survey ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Full Time ◽  
Test Results ◽  
Antibody Testing ◽  
And Gender

Objectives Lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) people and populations face myriad health disparities that are likely to be evident during the COVID-19 pandemic. The objectives of our study were to describe patterns of COVID-19 testing among LGBTQ+ people and to differentiate rates of COVID-19 testing and test results by sociodemographic characteristics. Methods Participants residing in the United States and US territories (N = 1090) aged ≥18 completed an internet-based survey from May through July 2020 that assessed COVID-19 testing and test results and sociodemographic characteristics, including sexual orientation and gender identity (SOGI). We analyzed data on receipt and results of polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2 and symptoms of COVID-19 in relation to sociodemographic characteristics. Results Of the 1090 participants, 182 (16.7%) received a PCR test; of these, 16 (8.8%) had a positive test result. Of the 124 (11.4%) who received an antibody test, 45 (36.3%) had antibodies. Rates of PCR testing were higher among participants who were non–US-born (25.4%) versus US-born (16.3%) and employed full-time or part-time (18.5%) versus unemployed (10.8%). Antibody testing rates were higher among gay cisgender men (17.2%) versus other SOGI groups, non–US-born (25.4%) versus US-born participants, employed (12.6%) versus unemployed participants, and participants residing in the Northeast (20.0%) versus other regions. Among SOGI groups with sufficient cell sizes (n > 10), positive PCR results were highest among cisgender gay men (16.1%). Conclusions The differential patterns of testing and positivity, particularly among gay men in our sample, confirm the need to create COVID-19 public health messaging and programming that attend to the LGBTQ+ population.

Sign in / Sign up

Export Citation Format

Share Document