Nephrology workforce in China: describing current status and evaluating the optimal capacity based on real-world data

Human Resources for Health

Research

Qing Li¹  Chenlu Bao¹  Jingyi Wu¹  Pengfei Li²  Chao Yang³  Luxia Zhang⁴ 

[1]Advanced Institute of Information Technology, Peking University, No.233 Yonghui Road, Xiaoshan District, 311215, Hangzhou, Zhejiang, China

[2]Advanced Institute of Information Technology, Peking University, No.233 Yonghui Road, Xiaoshan District, 311215, Hangzhou, Zhejiang, China

[3]National Institute of Health Data Science, Peking University, No.38 Xueyuan Road, Haidian District, 100191, Beijing, China

[4]Advanced Institute of Information Technology, Peking University, No.233 Yonghui Road, Xiaoshan District, 311215, Hangzhou, Zhejiang, China

[5]Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, 100034, Beijing, China

[6]Advanced Institute of Information Technology, Peking University, No.233 Yonghui Road, Xiaoshan District, 311215, Hangzhou, Zhejiang, China

[7]Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, 100034, Beijing, China

[8]National Institute of Health Data Science, Peking University, No.38 Xueyuan Road, Haidian District, 100191, Beijing, China

关键词: Nephrology workforce;    Workforce capacity;    Patient mobility;    Health policy;   

DOI  :  10.1186/s12960-023-00851-3

 received in 2023-04-18, accepted in 2023-08-03,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveThis study aims to characterize the current status of the nephrology workforce in China and evaluate its optimal capacity based on real-world patient mobility data.MethodsData on nephrologists in China were collected from two prominent online healthcare platforms using web crawlers and natural language processing techniques. Hospitalization records of patients with chronic kidney disease (CKD) from January 2014 to December 2018 were extracted from a national administrative database in China. City-level paths of patient mobility were identified. Effects of nephrology workforce on patient mobility were analyzed using multivariate Poisson regression models.ResultsAltogether 9.13 nephrologists per million population (pmp) were in practice, with substantial city-level variations ranging from 0.16 to 88.79. The ratio of nephrologists to the estimated CKD population was 84.57 pmp. Among 6 415 559 hospitalizations of patients with CKD, 21.3% were cross-city hospitalizations and 7441 city-level paths of patient mobility with more than five hospitalizations were identified. After making adjustment for healthcare capacity, healthcare insurance, economic status, and travel characteristics, the Poisson regression models revealed that the number of nephrologists in both the source city (incidence rate ratio [IRR] 0.99, per 1 pmp increase) and destination city (IRR 1.07, per 1 pmp increase) were independently associated with patient mobility. An IRR plateau was observed when the number of nephrologists exceeded 12 pmp in the source city, while a rapidly increasing IRR was observed beyond 20 pmp in the destination city.ConclusionsThe nephrology workforce in China exhibits significant geographic variations. Based on local healthcare needs, an optimal range of 12–20 nephrologists pmp is suggested.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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