Physician supply forecast: better than peering in a crystal ball?
Physician supply forecast: better than peering in a crystal ball?
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DOI：
10.1186/1478-4491-7-10
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发表时间：
2009-02-13
影响因子：
4.5
通讯作者：
Stordeur S
中科院分区：
文献类型：
--
作者：
Roberfroid D;Leonard C;Stordeur S
预测医生供应以应对未来的健康挑战是政策规划者的一项重要但复杂的任务。目前有一些预测工具，但这些工具的方法、优点和缺点并不简单，也不总是得到很好的评价。因此，本文件有两个目标：介绍现有预测方法的类型，并分析与方法有关的问题。在电子数据库Medline-Ovid、Embase和ERIC中进行文献综述。对各国规划经验的具体实例进行了分析。确定了四种主要的预测方法。供应预测方法确定了维持或在未来达到任意预定的服务水平所需的流入量。基于需求的方法估计人口未来使用的保健服务数量，以预测医生需求。以需求为基础的方法涉及界定和预测保健赤字，以便有足够的劳动力来解决这些问题。最后一种办法是以类似的人口和健康状况为基准确定卫生系统。这些不同的方法可以结合起来进行差距分析。这类预测在方法上面临诸多挑战：大多数情况下使用静态模型，没有评估其不确定性;往往缺乏有效和全面的数据来输入模型;快速变化的环境影响预测情景的可能性。因此，我们的审查中所包括的预测的内部和外部有效性似乎有限。没有单一的公认的方法来预测医生的需求。预测的价值在于其在确定决策者需要作出反应的当前和新出现的趋势方面的效用。真正的差距分析、对关键参数的有效监测和全面的劳动力规划是提高医生供应预测有用性的关键因素。
Anticipating physician supply to tackle future health challenges is a crucial but complex task for policy planners. A number of forecasting tools are available, but the methods, advantages and shortcomings of such tools are not straightforward and not always well appraised. Therefore this paper had two objectives: to present a typology of existing forecasting approaches and to analyse the methodology-related issues. A literature review was carried out in electronic databases Medline-Ovid, Embase and ERIC. Concrete examples of planning experiences in various countries were analysed. Four main forecasting approaches were identified. The supply projection approach defines the necessary inflow to maintain or to reach in the future an arbitrary predefined level of service offer. The demand-based approach estimates the quantity of health care services used by the population in the future to project physician requirements. The needs-based approach involves defining and predicting health care deficits so that they can be addressed by an adequate workforce. Benchmarking health systems with similar populations and health profiles is the last approach. These different methods can be combined to perform a gap analysis. The methodological challenges of such projections are numerous: most often static models are used and their uncertainty is not assessed; valid and comprehensive data to feed into the models are often lacking; and a rapidly evolving environment affects the likelihood of projection scenarios. As a result, the internal and external validity of the projections included in our review appeared limited. There is no single accepted approach to forecasting physician requirements. The value of projections lies in their utility in identifying the current and emerging trends to which policy-makers need to respond. A genuine gap analysis, an effective monitoring of key parameters and comprehensive workforce planning are key elements to improving the usefulness of physician supply projections.
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影响因子：
4.4
作者：
Holliman, CJ;Wuerz, RC;Hirshberg, AJ
通讯作者：
Hirshberg, AJ
影响因子：
3.2
作者：
JACOBY, I
通讯作者：
JACOBY, I
影响因子：
3.4
作者：
Cooper, RA;Getzen, TE;Laud, P
通讯作者：
Laud, P
影响因子：
4.4
作者：
Holliman, CJ;Wuerz, RC;Yeh, CS
通讯作者：
Yeh, CS
影响因子：
120.7
作者：
Angus, DC;Kelley, MA;Popovich, J
通讯作者：
Popovich, J