Abstract: FR-PO785

Forecasts for 2030 for the ESRDDialysis Workforce in the US

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Abraham, Ivo, University of Arizona, Tucson, Arizona, United States
  • Katragadda, Chinmayee, University of Arizona, Tucson, Arizona, United States
  • Katz, Michael, University of Arizona, Tucson, Arizona, United States
  • Erstad, Brian, University of Arizona, Tucson, Arizona, United States
  • Macdonald, Karen, Matrix 45, Tucson, Arizona, United States

Group or Team Name

  • For ESRD Workforce Investigators
Background

The continued rise in patients requiring renal replacement therapy impacts the ESRD/dialysis workforce demand. We aimed to estimate for 2030, on the demand side, the number of patients requiring dialysis; and on the supply side, workforce requirements for nephrologists, nurses (registered nurses and advanced practice nurses) and technicians (licensed practical/vocational nurses and dialysis technicians).

Methods

We forecasted the demand and supply sets using time series analysis with autoregressive integrated modeling (ARIMA). We used annual 2008-2014 USRDS data for the number of dialysis patients, dialysis centers, and FTE nurses and technicians; and 2008-2016 ASN data for nephrologists. We assumed similar dialysis practice patterns in 2014 and 2030.

Results

Forecasting models projected the following for 2030; all with adequate to superior goodness-of-fit. On the demand side, 689693 patients and 9911 centers. On the supply side 13107 nephrologists, 51381 FTE nurses, and 62243 FTE technicians. By 2030 the ratio of patients:nephrologist will have increased to 52.6:1; of patients:nurse to 13.4:1; and of patients:technician to 11.1:1. The supply differential of nephrologists is projected to be -386 shortage; of nurses +5679 surplus; and of technicians -2276 shortage.

Conclusion

Significant shortages of nephrologists and FTE technicians are anticipated by 2030 to meet the demand of patients requiring dialysis and the centers providing this dialysis. The shortage in centers can be addressed by enhanced operational efficiency and increased volume, but the latter is constrained by the need for geographically equitable access. Though the emerging use of advanced practice nurses may enable shifting some responsibilities’ from nephrologists, in general nurses can assume few if any nephrologists’ responsibilities. In addition to potentially being inappropriate professionally, wage differences make nurses fulfilling tasks of technicians economically not feasible. Funding for nephrology fellowship training needs to be diversified and recruitment intensified (inter)nationally; while novel training programs between the dialysis sector and community/technical colleges are required to address the technician demand.