Résumé :
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[BDSP. Notice produite par INIST BR0xNw6Y. Diffusion soumise à autorisation]. Context Two important areas of medicine, care of the critically ill and management of pulmonary disease, are likely to be influenced by the aging of the US population. Objective To estimate current and future requirements for adult critical care and pulmonary medicine physicians in the United States. Design, Setting, and Participants Analysis of existing population, patient, and hospital data sets and prospective, nationally representative surveys of intensive care unit (ICU) directors (n=393) and critical care specialists (intensivists) and pulmonary specialists (pulmonologists) (n=421), conducted from 1996 to 1999. Main Outcome Measures Influence of patient, physician, regional, hospital, and payer characteristics on current practice patterns ; forecasted future supply of and demand for specialist care through 2030. Separate models for critical care and pulmonary disease. Base-case projections with sensitivity analyses to estimate the impact of future changes in training and retirement, disease prevalence and management, and health care reform initiatives. Results In 1997, intensivists provided care to 36.8% of all ICU patients. Care in the ICU was provided more commonly by intensivists in regions with high managed care penetration. The current ratio of supply to demand is forecast to remain in rough equilibrium until 2007. (...)
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