General surgeon workforce in Tennessee in the era of the Affordable Care Act

Michael G. Jerkins, Ben L. Zarzaur, Timothy Fabian

Research output: Contribution to journalArticle

Abstract

Background: The Affordable Care Act of (ACA) 2010 may result in an increase in demand for surgery and may exacerbate any existing surgeon shortage. The purpose of this study was to examine factors associated with general surgeon workforce within counties in Tennessee in light of the ACA. Materials and methods: The Area Resource File for 2011 was utilized for this study. Counties with less than 3 active surgeons/100,000 persons were classified as shortage counties (SC). Counties with more than 6 active surgeons/100,000 persons were considered over-supply counties (OC). Demographic factors for each county were determined. Univariate and multivariable analysis was used to determine factors associated with SC. Results: There are 95 counties in the state and 45.3% were SC and 33.7% were OC. Sixty-nine (72.6%) of the counties had at least one hospital and 57 (60%) were in non-metro counties. Multivariable logistic regression analysis revealed that increasing percent uninsured in a county was positively associated with a SC. No other factors were associated with SC. To meet the cutoff of three surgeons per 100,000 in SC 23 general surgeons would be required. There was an excess of 219 general surgeons in OCs. Conclusions: There appears to be an adequate supply of general surgeons but a maldistribution exists, particularly if demand increases with the implementation of the ACA. If redistribution of surgeons does not occur through natural changes in supply and demand, careful policy changes may be considered to encourage redistribution of surgeon resources to meet demand in counties that are currently underserved.

Original languageEnglish (US)
Pages (from-to)26-30
Number of pages5
JournalJournal of Surgical Research
Volume184
Issue number1
DOIs
StatePublished - Jan 1 2013

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Patient Protection and Affordable Care Act
Surgeons
Logistic Models
Regression Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Surgery

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General surgeon workforce in Tennessee in the era of the Affordable Care Act. / Jerkins, Michael G.; Zarzaur, Ben L.; Fabian, Timothy.

In: Journal of Surgical Research, Vol. 184, No. 1, 01.01.2013, p. 26-30.

Research output: Contribution to journalArticle

Jerkins, Michael G. ; Zarzaur, Ben L. ; Fabian, Timothy. / General surgeon workforce in Tennessee in the era of the Affordable Care Act. In: Journal of Surgical Research. 2013 ; Vol. 184, No. 1. pp. 26-30.
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abstract = "Background: The Affordable Care Act of (ACA) 2010 may result in an increase in demand for surgery and may exacerbate any existing surgeon shortage. The purpose of this study was to examine factors associated with general surgeon workforce within counties in Tennessee in light of the ACA. Materials and methods: The Area Resource File for 2011 was utilized for this study. Counties with less than 3 active surgeons/100,000 persons were classified as shortage counties (SC). Counties with more than 6 active surgeons/100,000 persons were considered over-supply counties (OC). Demographic factors for each county were determined. Univariate and multivariable analysis was used to determine factors associated with SC. Results: There are 95 counties in the state and 45.3{\%} were SC and 33.7{\%} were OC. Sixty-nine (72.6{\%}) of the counties had at least one hospital and 57 (60{\%}) were in non-metro counties. Multivariable logistic regression analysis revealed that increasing percent uninsured in a county was positively associated with a SC. No other factors were associated with SC. To meet the cutoff of three surgeons per 100,000 in SC 23 general surgeons would be required. There was an excess of 219 general surgeons in OCs. Conclusions: There appears to be an adequate supply of general surgeons but a maldistribution exists, particularly if demand increases with the implementation of the ACA. If redistribution of surgeons does not occur through natural changes in supply and demand, careful policy changes may be considered to encourage redistribution of surgeon resources to meet demand in counties that are currently underserved.",
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