The current State of the acute care surgery workforce: A boots on the ground perspective

Am J Surg. 2018 Dec;216(6):1076-1081. doi: 10.1016/j.amjsurg.2018.08.023. Epub 2018 Sep 8.

Abstract

Background: Acute care surgery (ACS) was proposed to address a general surgery workforce crisis; however, the ACS workforce composition is unknown. A national survey was conducted to determine the differences in the emergency general surgery (EGS) workforce between ACS and non-ACS hospitals.

Methods: The American Hospital Association (AHA) Annual Survey of Hospitals database was queried to identify acute care general hospitals. A hybrid mail/electronic survey was sent to 2811 acute care hospitals that met the inclusion criteria of hospitals that care for adult patients (≥18 years old) with an emergency room (ER), ≥ 1 operating room (OR), and 24-h ER access. Hospitals were queried on whether they utilized an ACS model. The workforce composition among ACS and non-ACS hospitals was evaluated using X2 tests, t tests, and Wilcoxon rank-sum tests.

Results: Survey response was 60% (N = 1690). ACS hospitals had a higher proportion of emergency surgeons who were female (20% vs. 14%, p < 0.0001), newly-trained (17% vs 10%, p < 0.0001), critical care trained (78% vs. 31%, p < 0.0001), and who had an additional degree (35% vs. 13%, p < 0.0001). More ACS hospitals had 24/7 in-house OR nursing staff (72% vs. 15%, p < 0.0001) and ancillary staff.

Conclusions: ACS and non-ACS hospitals differ in their surgical workforce. It is clear that ACS hospitals have more human capital, which suggests that ACS hospitals may require more dedicated resources compared to non-ACS hospitals.

MeSH terms

  • Adult
  • Critical Care / organization & administration*
  • Emergency Service, Hospital / organization & administration*
  • Female
  • Health Workforce / organization & administration*
  • Hospitals
  • Humans
  • Male
  • Surveys and Questionnaires
  • United States