Send to

Choose Destination
Chest. 2019 Oct 14. pii: S0012-3692(19)34017-6. doi: 10.1016/j.chest.2019.09.030. [Epub ahead of print]

Adequacy of the Provider Workforce for Persons With Cardiopulmonary Disease.

Author information

Richard A. Henson Research Institute, Peninsula Regional Medical Center, Salisbury, MD; National Board for Respiratory Care, Overland Park, KS. Electronic address:
American Association for Respiratory Care, Irving, TX.
Department of Cardiopulmonary Sciences, Division of Respiratory Care, College of Health Sciences, Rush University, Chicago, IL.
Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI.
Commission on the Accreditation for Respiratory Care, Hurst, TX.
National Board for Respiratory Care, Overland Park, KS; Adult Respiratory Care, University of Michigan Health System, Ann Arbor, MI.



Access and quality of health care for cardiopulmonary disease in the United States ranks poorly compared with economically similar nations. No recent comprehensive assessment of the cardiopulmonary workforce is available. This systematic review was conducted to evaluate current published evidence about the workforce caring for persons with cardiopulmonary disease.


This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Structured searches of medical databases were conducted to find studies published from 2006 through 2016. Because of the paucity of quantitative data retrieved, a qualitative synthesis was conducted. Thematic analyses were performed on 15 identified articles through a process of open and axial coding.


There is published evidence of current and projected workforce shortages in all clinical settings where care of persons with cardiopulmonary disease occurs. Advanced practice providers complete much of their cardiopulmonary training on the job. The aging population and the advent of new medical interventions are projected to increase growth in health-care demand. Some physicians limit hiring of advanced practice providers because of a deficiency in formal cardiopulmonary training.


There is a gap in care between the needs of persons with cardiopulmonary disease and cardiopulmonary providers. Strategies resolving this problem may include one or more approaches that reduce the administrative burden associated with current care and assure the availability of suitably trained providers.


advanced practice; cardiac; cardiopulmonary disease; education; employment; nurse practitioner; physician; physician assistant; respiratory; staffing; training; workforce shortage

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center