Demand For and Supply of Geriatricians in Nursing Homes

The nursing home (NH) population has grown to 1.6 million people and will double by 2030. Among them, 88.3% of NH residents are over 65 years old and at risk of chronic diseases and functional disabilities. This study assessed the supply of primary care physicians with certified geriatric training, i.e., geriatricians, in addressing the healthcare service needs of the NH elderly population. English-written articles between 1985 and 2010 with data on the trends of the NH service needs and the supply of geriatric workforce were reviewed. Several indicators noted that NH service needs have increased. The percentage of NH residents who needed 5 Activities of Daily Living (ADL) services significantly rose from 8.1% in 1995 to 51.1% in 2004. Additionally, 76% of NH residents have at least one chronic diseases and the average length of NH stay has increased from 611 days in 1985 to 835 days in 2004. Meanwhile, the absolute number of geriatricians decreased from 9,256 in 1998 to 6,435 in 2005. Pipeline data also indicates a decline in primary care physicians receiving certification in geriatrics and a projected ratio of only one geriatrician for every 2,000 elders by 2030. The health service needs of NH residents have greatly expanded due to the growing size, worsening functionality, and increased burden of chronic diseases of the elderly. Nevertheless, the geriatrician workforce is unprepared for this dramatic expansion of needs. Developing and maintaining a high-quality geriatric workforce are imperative to address the burgeoning quality care needs at Nursing homes.