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2010年11月3日星期三
Demand For Anesthesia In The Us : 2010
Economics and HealthThe job loss caused by the recession directly impacts all physicians income. When millions of people lose their jobs, they also lose their health care insurance and physicians lose patients that can pay. Hopefully the job loss is a short term set back, but it does affect demand for services and income for physicians immediately. This in effect destroys the underlying projections of the growth of demand made just a few years ago. Until the economy picks up and the unemployment drops from 10% to the 4 to 5% area there is a great possibility that the demand for all health care services based on per crash assumptions is optimistic.Shortage of AnesthesiologistsFrom 1995 the number of anesthesiologists graduating from residency programs decreased. According to the American Society of Anesthesiologists the number of American anesthesia residency graduates decreased from 1,547 in 1995 to only 392 in 2000. During the same period, the number of practicing anesthesiologists increased by less than 9 percent, according to the AMA. This compares with a 13 percent increase in the number of physicians in all specialties. CRNAsThe rising cost of health care can dramatically affect demand for physicians services. CRNAs, who can perform many of the routine duties of physicians at a fraction of the cost, may be increasingly used. Furthermore, demand for physicians services is highly sensitive to changes in health care reimbursement policies. If changes to health coverage result in higher out-of-pocket costs for consumers, they may demand fewer physician services.In rural settings, CRNAs are the sole anesthesia providers in nearly two thirds of all hospitals. CRNAs are also the main provider of obstetrical anesthesia in the United States.Increase in the Demand for Anesthesia ServicesThe National Center for Health Statistics states inpatient surgeries were flat between 1994 and 2000. While the number of anesthesia providers has remained relatively constant in recent years, surgical volumes have increased nationwide, placing greater demand on the providers of anesthesia services.Bad Economy and Aging PopulationThe recent stock market collapse is having a major impact on older physicians decisions of all specialties. Many doctors are postponing retirement for a few years, because of the losses they sustained in their retirement accounts. However, even a few years delay of retirement won't address the increased demands caused by this impending loss of experienced physicians. This postponement has already resulted in fewer jobs being offered and graduating residents not finding as many good opportunities as before. Some residents rather than committing themselves to less desirable full time jobs are opting for locum Anesthesia jobs. Health Insurance ReformThe final question is the outcome of national health reform. Will there be any changes at all. This debate has frozen decision making for many in health care. If the health care reform actually happens in increasing the enrollment into health care insurance then the long term the aging population and these increased numbers should push demand for services and income higher. However, no one yet knows what will happen to reimbursement rates from Medicare. Already there has been some lowering of rates they pay in Radiology which has directly impacted that specialty. The question is will there be more rates cut that will affect all specialties including Anesthesia.
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