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U.S. Emergency Care System at Risk of Critical Workforce Shortages According to UAlbany's Center for Health Workforce Studies
Rural areas across the nation often lack doctors certified in emergency medicine

Contact: Catherine Herman (518) 956-8150

ALBANY, N.Y. (August 4, 2006) -- Emergency care systems in the United States are at serious risk of critical shortages in staffing in the near future, due to worsening shortages of registered nurses (RNs), a maldistribution of board-certified emergency medicine (EM) physicians between urban and rural areas, and challenges retaining emergency medical technicians (EMTs) according to a new study by the Center for Health Workforce Studies at the University at Albany's School of Public Health. The report, The Emergency Care Workforce in the U.S. is a study of the national emergency care workforce in the United States, including pre-hospital emergency services, emergency departments (EDs) in hospitals, freestanding urgent care centers, and teams dispatched by local, state, or federal governments or volunteer organizations such as the Red Cross in response to widespread emergency or disaster.

"The emergency care workforce in the United States will face a number of challenges in the coming years, problems that will be exacerbated by the retirement of baby boomers," said Jean Moore, director of CHWS and lead author of the study. "These are issues we must be prepared to address now, before we are confronted by a pandemic or another health crisis that strains our current system beyond the breaking point."

Among the key findings of the report:

Shortages in the emergency care workforce are likely. Given the increases in projected demand for emergency medical care services in the United States resulting from a variety of factors, the supply of emergency care workers may not be sufficient.

  • Emergency care services are currently affected by the shortage of RNs. Some studies indicate that EDs are one of the most common locations of RN openings in hospitals. This will persist as RN shortages worsen.
  • The supply of board-certified EM physicians may not be adequate to meet demand.
    - An annual survey of residents completing training in New York in EM indicates a strong job market relative to other specialties, implying employer competition for EM graduates.

    - Studies of physicians in New York and New Mexico show that many physicians in rural EDs are not board-certified in EM.

    - Nearly 20 percent of physicians reporting their specialty as EM worked as independent contractors, compared to four percent of all physicians. The practice of hiring contract physicians for EDs is especially prevalent in rural areas.
  • While EMTs are not generally seen as being in short supply, a 2004 survey of emergency medical service directors in rural areas indicates that high rates of turnover make recruitment and retention of EMTs a continuing concern.

Future issues. A number of issues may substantially affect future demand for emergency care services and workers.

  • There is a growing concern about the potential for mass casualty incidents or bioterrorism threats, leading to more focused efforts in emergency preparedness planning. An effective response to such events may require more personnel and different strategies for providing care. These personnel also need training in new skills to prepare them for scenarios they may never have encountered in training or in practice.
  • The aging of America will lead to a growing segment of the population placing greater demands on the emergency care system.

    - Older adults use more emergency services than younger adults: 50 emergency visits per 100 persons for those 65 and over, compared to 42 visits for those ages 18 through 44 in 2000.

    - Older adults also need different types of emergency services than young adults and children. They are much more likely to need emergency care as a result of chronic conditions, and are more likely to suffer from co-occurring conditions.
  •  By federal law, hospital EDs must provide care to all patients, regardless of ability to pay. Higher rates of underinsurance and uninsurance lead to increasing use of EDs for non-emergency care.
  • Current health workforce shortages and geographic maldistribution of health care workers may worsen.
  • Increasing numbers of hospitals are closing their EDs.
  • The development and use of new health care technologies may potentially increase the efficiency and effectiveness of emergency medical care, but may also require new skills of emergency care personnel.

Read the Full Report (67 pages) >>
(PDF file, requires Adobe Acrobat Reader)

Read the Executive summary (5 pages) >>
(PDF file, requires Adobe Acrobat Reader) 

The Center for Health Workforce Studies at the University at Albany's School of Public Health conducts studies of the supply, demand, use, and education of the health workforce, and collects and analyzes data to understand workforce dynamics and trends. It is one of six regional centers devoted to health workforce studies with a cooperative agreement with U.S. Department of Health's Health Resources and Services Administration/Bureau of Health Professions.

Through its partnership with the New York State Dept. of Health, UAlbany's School of Public Health offers students immediate access to internships at the Health Department, Albany Medical College, and variety of other public and private health institutions throughout New York. Students have unique access to study the most profound health issues facing us today: the threat of bioterrorism; the spread of HIV/AIDS and other emerging diseases; the lack of affordable and accessible healthcare for individuals and families; environmental hazards; substance abuse and social violence; maternal mortality in developing countries; the promises and threats of genetic engineering; protecting food and water supplies. For more information, visit University at Albany's School of Public Health.


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