Trends in the U.S. Health Care Workforce: A Decade of Staffing and Compensation Practices Across Care Settings.

IF 2.8 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Medical Care Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI:10.1097/MLR.0000000000002179

Nina Rodriguez, Logan D Cho, Stavros G Memtsoudis, Jashvant Poeran

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引用次数: 0

Abstract

Background: Nurses are integral to patient care in US hospitals, yet high burnout rates exacerbated by staffing shortages and the COVID-19 pandemic pose challenges in retaining nursing staff. Understanding staffing dynamics and trends in the care team composition is vital to improve care and address the well-being of the health care workforce.

Objective: To examine trends in employment and compensation among registered nurses (RNs), physicians, nurse practitioners (NPs), physician assistants (PAs), medical assistants (MAs), licensed practical and vocational nurses (LPN/LVNs), and administrative staff from 2012 to 2022.

Methods: Data from the Occupational Employment and Wage Statistics (OEWS) was utilized to analyze employment and wage trends in hospitals and physician offices. The annual RN-to-physician, NP-to-physician, and PA-to-physician ratios and change in employment and compensation over time were calculated.

Results: Although hospital RN employment increased by 12%, this was outpaced by physician (40%), NP (105%), PA (38%), and MA (44%) employment growth. The hospital RN-to-physician ratio declined by 21%, whereas the NP-to-physician and PA-to-physician ratios increased by 46% and 28%, respectively. In offices, the NP-to-physician ratio increased by 107%, whereas the RN-to-physician ratio remained stable. Wage growth for all clinical hospital staff increased around 30%, while physicians saw wage growth of 43%.

Discussion: The declining RN-to-physician ratio in hospitals signals a shift in the care team composition. While APP employment has drastically risen, RN growth has lagged significantly behind. Urgent action is needed to optimize staffing strategies to safeguard patient care.

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趋势在美国卫生保健人力：十年的人员配备和补偿实践在整个护理设置。

背景：护士是美国医院患者护理不可或缺的一部分，但人员短缺和COVID-19大流行加剧了高倦怠率，给留住护理人员带来了挑战。了解护理团队组成中的人员配置动态和趋势对于改善护理和解决卫生保健工作人员的福祉至关重要。目的：了解2012 - 2022年注册护士（RNs）、内科医生、执业护士（NPs）、医师助理（PAs）、医疗助理（MAs）、执业和职业护士（LPN/LVNs）和行政管理人员的就业和薪酬趋势。方法：利用职业就业与工资统计（OEWS）的数据，分析医院和医生办公室的就业和工资趋势。计算了年度注册护士对医生、np对医生和pa对医生的比率以及就业和薪酬随时间的变化。结果：虽然医院注册护士的就业增长了12%，但超过了医生（40%）、NP（105%）、PA（38%）和MA（44%）的就业增长。医院护士对医生的比率下降了21%，而护士对医生和助理医生对医生的比率分别上升了46%和28%。在办公室，护士与医生的比例增加了107%，而护士与医生的比例保持稳定。所有临床医院员工的工资增长了约30%，而医生的工资增长了43%。讨论：医院注册护士与医生比例的下降标志着护理团队组成的转变。虽然APP的就业率大幅上升，但RN的增长却明显落后。需要采取紧急行动，优化人员配置战略，以保障患者护理。

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来源期刊

Medical Care 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

3.30%

发文量

228

审稿时长

3-8 weeks

期刊介绍： Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.