台灣復健專科醫師人力需求推估

Abstract

目的 臺灣即將進入超高齡社會，因此，老年人口的復健醫療需求預期會逐漸增加，而另一方面，兒童復健與早期療育的需求則可能會隨著少子化而減少。以上臺灣超高齡化與少子化趨勢對於未來復健專科醫師人力需求之影響需要綜合評估。本研究目的為推估未來台灣復健科門診與住院醫療需求，並推估未來台灣復健專科醫師人力需求。 方法 本研究使用的資料來源為主計處所發布的統計資料以及全民健保資料庫等資料，復健專科醫師人數資料來源為台灣復健醫學會。我們使用線性迴歸模型進行分析與推估。首先建立各年齡層每人年平均復健科門診次數與復健科住院次數的預測模型，逐年推估2021-2035年兒童、成人、老人三個年齡層每人年平均復健科門診次數與每人年平均復健科住院次數，並基於2021-2035年台灣中推估人口數，推估台灣復健科門診與住院醫療服務需求。接下來再以此2021-2035年份全國復健科門診與住院需求推估台灣復健專科醫師人力需求。 結果 兒童、成人、老人三個年齡層推估在2021至2035年間每人年平均復健科門診次數都有明顯上升的趨勢，分別上升了60％、45％、40％。再乘以各相對應2021至2035年的中推估人口數目之後，可見這三個年齡層其推估復健門診需求量在2021-2035間都有明顯上升。其中以老年人的門診需求量增加最為明顯，增加了128％。在2021-2035年間的每人年平均住院次數，在兒童並沒有明顯增加，而成人與老人分別增加了35％與28％，再乘以2021至2035年的中推估人口數，顯示老年人口在2021-2035年間的復健住院需求量上升相當顯著，增加了101％，成年人口的住院需求量則增加有限，僅增加16％，而在兒童人口的復健住院需求量卻逐漸下降。推估台灣復健專科醫師人力需求由2021年1351人增加至2035年的2159名，每年大約需要增加60名。 討論及結論 本研究結果顯示在2021-2035年間復健科門診與住院醫療需求量均呈現上升的趨勢，此外，推估結果顯示未來老年人的復健醫療需求量將會增加最多。相對應的復健專科人力需求推估亦顯示在2021-2035年間，平均每年約需增加60名復健專科醫師方能滿足台灣整體復健醫療需求。建議未來可酌予增加每年復健專科醫師訓練員額以補充人力，此外，復健專科應強化發展老人復健的領域。

Purpose: Taiwan is about to enter a super-aged society, and the child population is expected to decline. Therefore, the demand for geriatric rehabilitation is likely to increase, while the demand for pediatric rehabilitation, on the other hand, is likely to decrease. The impact of these trends on the future demand for physiatrists in Taiwan needs to be evaluated. This study aims to estimate the future demand for outpatient and inpatient rehabilitation services in Taiwan and forecast the workforce demand for physiatrists in Taiwan. Methods: The data used in this study were from the Directorate-General of Budget, Accounting and Statistics, and the National Health Insurance Database. The number of physiatrists was obtained from the Taiwan Academy of Physical Medicine and Rehabilitation Rehabilitation. We used a linear regression model for analysis and prediction. We first developed a model to predict the number of annual rehabilitation outpatient visits and hospitalizations per person for each age group, projected the number of rehabilitation outpatient visits and hospitalizations for children, adults, and the elderly from 2021 to 2035, and estimated the demand for rehabilitation services in Taiwan based on the projected population in Taiwan from 2021 to 2035. Then, we used the demand for rehabilitation services from 2021 to 2035 to forecast the workforce demand for physiatrists in Taiwan. Results: The predicted average number of annual rehabilitation outpatient visits per person for children, adults, and the elderly all showed a significant increase from 2021 to 2035, rising by 60%, 45%, and 40%, respectively. They were multiplied by the corresponding projected population from 2021 to 2035 to estimate the demand for rehabilitation outpatient services, which increased significantly from 2021 to 2035 for these three age groups. The most significant increase in demand for outpatient services is for the elderly, which increases by 128%. The number of annual hospitalizations per person between 2021 and 2035 does not increase significantly for children, but increases by 35% for adults and 28% for seniors. Multiplying this by the projected population from 2021 to 2035 shows that the demand for rehabilitation hospitalization among the elderly population increases significantly by 101% between 2021 and 2035, while the demand for hospitalization among the adult population increases only marginally by 16%, and the demand for rehabilitation hospitalization among the pediatric population gradually decreases. The projected workforce demand for physiatrists increased from 1,351 in 2021 to 2,159 in 2035, requiring an increase of approximately 60 physiatrists per year. Conclusions: This study has shown that the demand for rehabilitation outpatient visits and hospitalizations rises from 2021 to 2035. Moreover, the demand for rehabilitation services for the elderly is estimated to increase the most. The forecasting workforce demand for physiatrists shows that an average of 60 additional physiatrists per year will be required to meet the overall demand for rehabilitation services in Taiwan from 2021 to 2035. It is suggested that the number of resident training positions for physiatrists could be increased in the future to supplement the workforce, and the development of geriatric rehabilitation should be strengthened.