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Do we have the ACHD physician resources we need to care for the burgeoning ACHD population?

Fatima M Ezzeddine1, Tabitha Moe2, Georges Ephrem3

  • 1Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Congenital Heart Disease
|April 5, 2019
PubMed

Insights

The United States faces a shortage of adult congenital heart disease (ACHD) physicians, with at least 170 more needed to meet patient demand. Current physician-to-patient ratios vary significantly by region, impacting care delivery for this growing population.

Area of Science:

  • Cardiology
  • Public Health
  • Healthcare Workforce Analysis

Background:

  • The growing population of adults with congenital heart disease (ACHD) faces challenges in accessing specialized care due to a limited number of ACHD physicians.
  • Current data on the adequacy of ACHD physician resources in the U.S. is scarce, with existing estimates often based on Canadian data.
  • A critical need exists to assess the current and future physician:patient ratios within the U.S. ACHD population.

Purpose of the Study:

  • To evaluate the adequacy of physician:patient ratios for adult congenital heart disease (ACHD) care nationwide and regionally within the United States.
  • To identify disparities in ACHD physician distribution across different metropolitan statistical areas (MSAs) and states.
  • To quantify the number of additional ACHD-certified physicians required to meet optimal patient care standards.

Main Methods:

  • Analysis of physician data from the Adult Congenital Heart Association (ACHA) website.
  • Cross-referencing ACHA-listed physicians with the American Board of Internal Medicine (ABIM) for board certification verification.
  • Utilizing 2016 U.S. Census Bureau data for metropolitan area and statewide population estimates.

Main Results:

  • The U.S. has 320 board-certified ACHD cardiologists, with 161 not listed on the ACHA website, alongside 115 self-identified ACHD programs.
  • Significant regional variations exist, with Raleigh-Cary, NC, having the best physician:patient ratio and Riverside-San Bernardino-Ontario, CA, the worst.
  • Washington, D.C. shows the best state-level ratio, while Indiana has the worst, highlighting geographic inequities in ACHD care access.

Conclusions:

  • A substantial national shortage of ACHD-certified physicians is projected, threatening the capacity to manage the increasing needs of the ACHD population.
  • Achieving an optimal patient:physician ratio of 1000:1 necessitates the immediate addition of at least 170 board-certified ACHD physicians.
  • Addressing this physician shortage is crucial for ensuring equitable and adequate care delivery for all adults with congenital heart disease.
Abstract

Keywords:
United Statescongenital heart diseasephysicianprogram

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