The Future of Radiation Oncology in the United States From 2010 to 2020: Will Supply Keep Pace With Demand?

2010 ◽  
Vol 28 (35) ◽  
pp. 5160-5165 ◽  
Author(s):  
Benjamin D. Smith ◽  
Bruce G. Haffty ◽  
Lynn D. Wilson ◽  
Grace L. Smith ◽  
Akshar N. Patel ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Oncology ◽  
The United States ◽  
Census Bureau ◽  
Population Projections ◽  
Full Time ◽  
Full Time Equivalent ◽  
Radiation Oncologists ◽  
Number Of Patients ◽  
Using Data

Purpose Prior studies forecasted an incipient shortage of medical oncologists as a result of the aging US population, but the radiation oncology workforce has not been studied. Accordingly, we projected demand for radiation therapy and supply of radiation oncologists in 2010 and 2020 to determine whether a similar shortage may exist for this specialty. Methods Demand for radiation therapy in 2010 and 2020 was estimated by multiplying current radiation utilization rates (as calculated with Surveillance, Epidemiology, and End Results data) by population projections from the Census Bureau. Supply of radiation oncologists was projected using data from the American Board of Radiology inclusive of current radiation oncologists and active residents, accounting for variation in full-time equivalent status and expected survival by age and sex. Results Between 2010 and 2020, the total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 22%, from 470,000 per year to 575,000 per year. In contrast, assuming that the current graduation rate of 140 residents per year remains constant, the number of full-time equivalent radiation oncologists is expected to increase by only 2%, from 3,943 to 4,022. The size of residency training classes for the years 2014 to 2019 would have to double to 280 residents per year in order for growth in supply of radiation oncologists to equal expected growth in demand. Conclusion Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020. Research is needed to explore strategies to enhance capacity to deliver quality radiation therapy despite increased patient loads.

scholarly journals Japanese Structure Survey of Radiation Oncology in 2011

2019 ◽  
Vol 60 (6) ◽  
pp. 786-802 ◽  
Author(s):  
Hodaka Numasaki ◽  
Teruki Teshima ◽  
Tetsuo Nishimura ◽  
Keizo Akuta ◽  
Yutaka Ando ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Intensity Modulated Radiotherapy ◽  
Conformal Radiotherapy ◽  
Annual Number ◽  
Full Time ◽  
Full Time Equivalent ◽  
Energy Functions ◽  
Radiation Oncologists ◽  
Patient Load ◽  
Medical Physicists

ABSTRACT We evaluated the evolving structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From March 2012 to August 2015, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2011. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 211 000 and 250 000, respectively. Additionally, the estimated cancer incidence was 851 537 cases with approximately 24.8% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 836), telecobalt (n = 3), Gamma Knife (n = 46), 60Co remote afterloading system (RALS; n = 24), and 192Ir RALS (n = 125). The LINAC system used dual-energy functions in 619 units, 3D conformal radiotherapy functions in 719 and intensity-modulated radiotherapy (IMRT) functions in 412. There were 756 JRS or JASTRO-certified radiation oncologists, 1018.5 full-time equivalent (FTE) radiation oncologists, 2026.7 FTE radiotherapy technologists, 149.1 FTE medical physicists, 141.5 FTE radiotherapy quality managers and 716.3 FTE nurses. The frequency of IMRT use significantly increased during this time. To conclude, although there was a shortage of personnel in 2011, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility.

scholarly journals Japanese structure survey of radiation oncology in 2012

2019 ◽  
Vol 61 (1) ◽  
pp. 146-160
Author(s):  
Hodaka Numasaki ◽  
Teruki Teshima ◽  
Yutaka Ando ◽  
Keizo Akuta ◽  
Hiroshi Ikeda ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Japanese Society ◽  
Intensity Modulated Radiotherapy ◽  
Conformal Radiotherapy ◽  
Annual Number ◽  
Full Time ◽  
Full Time Equivalent ◽  
Radiological Society ◽  
Radiation Oncologists ◽  
Medical Physicists

ABSTRACT This paper describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From March 2013 to August 2016, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2012. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 213 000 and 251 000, respectively. Additionally, the estimated cancer incidence was 865 238 cases with ~24.6% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 864), telecobalt (n = 0), Gamma Knife (n = 44), 60Co remote afterloading system (RALS; n = 23) and 192Ir RALS (n = 130). The LINAC system used dual-energy functions in 651 units, 3D conformal radiotherapy functions in 759 and intensity-modulated radiotherapy (IMRT) functions in 466. There were 792 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists, 1061.6 full-time equivalent (FTE) radiation oncologists, 2124.2 FTE radiotherapy technologists, 181.3 FTE medical physicists, 170.9 FTE radiotherapy quality managers and 841.5 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2012.

scholarly journals Japanese structure survey of radiation oncology in 2013

2020 ◽  
Vol 61 (5) ◽  
pp. 799-816
Author(s):  
Hodaka Numasaki ◽  
Teruki Teshima ◽  
Yasuo Okuda ◽  
Kazuhiko Ogawa ◽  
Keyword(s):  
Radiation Oncology ◽  
Japanese Society ◽  
Intensity Modulated Radiotherapy ◽  
Conformal Radiotherapy ◽  
Annual Number ◽  
Full Time ◽  
Full Time Equivalent ◽  
Radiological Society ◽  
Radiation Oncologists ◽  
Medical Physicists

ABSTRACT This paper describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From December 2014 to July 2017, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2013. Data were analyzed based on institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 216 000 and 257 000, respectively. Additionally, the estimated cancer incidence was 862 452 cases with ~25.0% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (LINAC; n = 880), Gamma Knife (n = 45), 60Co remote afterloading system (RALS; n = 23) and 192Ir RALS (n = 128). The LINAC system used dual-energy functions in 675 units, 3D conformal radiotherapy functions in 785 and intensity-modulated radiotherapy (IMRT) functions in 494. There were 831 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists, 1130.6 full-time equivalent (FTE) radiation oncologists, 2214.6 FTE radiotherapy technologists, 196.6 FTE medical physicists, 183.8 FTE radiotherapy quality managers and 856.7 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2013.

Disproportionately Overrepresented: Women in Local Elected Offices

2018 ◽  
Vol 50 (3) ◽  
pp. 165-176 ◽  
Author(s):  
Ethan M. Bernick ◽  
Brianne Heidbreder
Keyword(s):  
United States ◽  
Maximum Likelihood ◽  
Gender Norms ◽  
The United States ◽  
Census Bureau ◽  
National Association ◽  
County Level ◽  
Political Factors ◽  
Using Data ◽  
The U.S

This research examines the position of county clerk, where women are numerically disproportionately over-represented. Using data collected from the National Association of Counties and the U.S. Census Bureau, the models estimate the correlation between the county clerk’s sex and county-level demographic, social, and political factors with maximum likelihood logit estimates. This research suggests that while women are better represented in the office of county clerk across the United States, when compared to other elective offices, this representation may be because this office is not seen as attractive to men and its responsibilities fit within the construct of traditional gender norms.

scholarly journals Population projections for all U.S. counties by age, sex, and race controlled to the Shared Socioeconomic Pathways

2018 ◽  
Author(s):  
Mathew Hauer
Keyword(s):  
Census Data ◽  
Age Groups ◽  
The United States ◽  
Population Projections ◽  
Leslie Matrix ◽  
Ex Post ◽  
Ex Post Facto ◽  
Using Data ◽  
And Control ◽  
Cohort Change

Small area and subnational population projections are important for understanding long-term demographic changes. I provide county-level population projections by age, sex, and race in five-year intervals for the period 2015-2100 for all U.S. counties. Using historic U.S. census data in temporally rectified county boundaries and race groups for the period 1990-2015, I calculate cohort-change ratios (CCRs) and cohort-change differences (CCDs) for eighteen five-year age groups (0-85+), two sex groups (Male and Female), and four race groups (White NH, Black NH, Other NH, Hispanic) for all U.S counties. I then project these CCRs/CCDs using ARIMA models as inputs into Leslie matrix population projection models and control the projections to the Shared Socioeconomic Pathways. I validate the methods using ex-post facto evaluations using data from 1969-2000 to project 2000-2015. My results are reasonably accurate for this period. These data have numerous potential uses and can serve as inputs for addressing questions involving sub-national demographic change in the United States.

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.

scholarly journals Integrating nurse assignment in outpatient chemotherapy appointment scheduling

OR Spectrum ◽  
2020 ◽  
Vol 42 (4) ◽  
pp. 935-963
Author(s):  
Alireza F. Hesaraki ◽  
Nico P. Dellaert ◽  
Ton de Kok
Keyword(s):  
Drug Administration ◽  
Weighted Average ◽  
Mixed Integer ◽  
Mixed Integer Program ◽  
Drug Preparation ◽  
Full Time ◽  
Start Time ◽  
Full Time Equivalent ◽  
Outpatient Chemotherapy ◽  
Number Of Patients

Abstract In outpatient chemotherapy, nurses administer the drugs in two steps. In the first few minutes of each appointment, a nurse prepares the patient for infusion (drug administration). During the remainder of the appointment, the patient is monitored by nurses and if needed taken care of. One nurse must be assigned to prepare the patient and set up the infusion device. However, a nurse who is not busy setting up may simultaneously monitor up to a certain number of patients who are already receiving infusion. The prescribed infusion durations are significantly different among the patients on a day at a clinic. We formulate this problem as a multi-criterion mixed integer program. The appointments should be scheduled with start times close to patients’ ready times, balanced workload among nurses, few nurse changes during appointments, and few nurse full-time equivalent (FTE) assigned to the schedule of the day. As the number of nurse FTEs is an output of the model rather than a fixed input, the clinic can use the nursing capacity more efficiently, i.e., with less labor cost. We develop a 3-stage heuristic for finding criterion points with the minimum weighted average deferring time of appointments for the minimum feasible number of nurse FTEs or a desired value above that. By not constraining the number of chairs or beds, we can find solutions with better (dominating) criterion points. Drug preparation, oncologist visit, and the laboratory test can be scheduled based on the drug administration appointment start time. Thus, the drug administration resources are efficiently used with desirable performance in taking the interests and requirements of various stakeholders into consideration: patients, nurses, oncologists, pharmacy, and the clinic.

Current and Future Utilization of Services From Medical Oncologists

2008 ◽  
Vol 26 (19) ◽  
pp. 3242-3247 ◽  
Author(s):  
Joan L. Warren ◽  
Angela B. Mariotto ◽  
Angela Meekins ◽  
Marie Topor ◽  
Martin L. Brown
Keyword(s):  
United States ◽  
The United States ◽  
Population Projections ◽  
Cancer Site ◽  
Patients With Cancer ◽  
Medical Oncologists ◽  
Number Of Patients ◽  
Initial Care ◽  
Number Of Visits ◽  
End Results

Purpose There is limited information on the current use of oncologists and projections of future need. This analysis assesses current utilization patterns and projects the number of people with cancer and their use of oncologists’ services through 2020. Methods Data from the Surveillance, Epidemiology, and End Results cancer registries and Medicare physician claims were used to estimate oncologists’ services from 1998 to 2003. We estimated the portion of patients with cancer who saw an oncologist, the mean number of visits, and the clinical setting where care was provided. Care was divided into initial, continuing, and last-year-of-life phases. Projections for future number of patients with cancer and visits were calculated by applying incidence and prevalence rates derived from Surveillance, Epidemiology, and End Results data to census population projections through 2020. Results The percentage of patients who saw an oncologist was 47% during the initial-care phase, 36% during the continuing-care phase, and 70% in the last year of life. The number of visits varied by age, sex, cancer site, and phase. The total number of cancer patients in the United States is projected to increase 55%, from 11.8 million in 2005 to 18.2 million in 2020. Total oncology visits are projected to increase from 38 million in 2005 to 57 million in 2020. Conclusion Utilization of oncologists’ services will increase appreciably between 2005 and 2020; this will be driven predominantly by an increase in survivors of cancer and by the aging of the population. The United States may face an acute shortage of medical oncologists if efforts are not taken to meet this growing need.

scholarly journals Using data to strategically deploy staffing resources

2018 ◽  
Vol 39 (3/4) ◽  
pp. 166-171
Author(s):  
Michael Williams
Keyword(s):  
Performance Indicator ◽  
Service Level ◽  
Design Stage ◽  
Full Time ◽  
Service Level Agreements ◽  
Full Time Equivalent ◽  
Content Type ◽  
Staffing Levels ◽  
Staffing Requirement ◽  
Using Data

Purpose The environmentally controlled library warehouse stores ten million collection items and its team of staff provides a delivery service to the students and researchers. Statistics show that the demand for the service was much higher than the forecast at the design stage and, as a result, the operationally intensive environment had bottlenecks and backlogs, which were affecting the service-level agreements. It was clear that the staffing levels were inadequate to meet the demand, so there was a need to capture data to enable evidence-based decision making to restructure and supplement staffing. The paper aims to discuss these issues. Design/methodology/approach Each of the activities undertaken by staff were observed and timed over extended periods, which resulted in detailed measurements for each elemental task. On the basis of known demand for services, the author was able to extrapolate these measurements to model the demand on services and, therefore, the staffing requirement for a whole year. Findings The author was able to provide evidence to show that the levels of staffing were inadequate and two further full-time equivalent staff were required. The data also highlighted specific areas that required higher and lower levels of resourcing than those were currently provided. Originality/value The research was motivated by operational need in an environment where meeting service-level agreements is a key performance indicator. The methods can be applied to many library activities and are especially applicable to repetitive or high-intensity tasks. It is equally valuable in library operations where there is a perception that staffing levels are inadequate but it is not clear how additional staffing should be deployed.

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