A needs-based methodology to project physicians and nurses to 2030: the case of the Kingdom of Saudi Arabia

Abstract

Background The Kingdom of Saudi Arabia (KSA), as part of its 2030 National Transformation Program, set a goal of transforming the healthcare sector to increase access to, and improve the quality and efficiency of, health services. To assist with the workforce planning component, we projected the needed number of physicians and nurses into 2030. We developed a new needs-based methodology since previous global benchmarks of health worker concentration may not apply to the KSA. Methods We constructed an epidemiologic “needs-based” model that takes into account the health needs of the KSA population, cost-effective treatment service delivery models, and worker productivity. This model relied heavily on up-to-date epidemiologic and workforce surveys in the KSA. We used demographic population projections to estimate the number of nurses and physicians needed to provide this core set of services into 2030. We also assessed several alternative scenarios and policy decisions related to scaling, task-shifting, and enhanced public health campaigns. Results When projected to 2030, the baseline needs-based estimate is approximately 75,000 workers (5788 physicians and 69,399 nurses). This workforce equates to 2.05 physicians and nurses per 1000 population. Alternative models based on different scenarios and policy decisions indicate that the actual needs for physicians and nurses may range from 1.64 to 3.05 per 1000 population in 2030. Conclusions Based on our projections, the KSA will not face a needs-based health worker shortage in 2030. However, alternative model projections raise important policy and planning issues regarding various strategies the KSA may pursue in improving quality and efficiency of the existing workforce. More broadly, where country-level data are available, our needs-based strategy can serve as a useful step-by-step workforce planning tool to complement more economic demand-based workforce projections.

Modeling Health Workforce Planning in Specialties and Subspecialties: A Need-Adjusted Demand Model

“…Considering the population and its changes (28)(29)(30)(31)(32), dividing disease into categories (31), demographic (33) and epidemiologic changes (34)(35)(36), insurance status (14,37,38), economic condition (28,(39)(40)(41), health literacy (37,42), general health (42), and service accessibility (37) are in line with the results of other studies or recommended by them. Using full-time equivalent factor, number (31) and average time (31,43) of visits, or number of services (30,32,43) are in line with the results of other studies, and the present study used them to calculate the number of referrals and conversion coefficient of referrals to the full-time equivalent of physicians.…”

Implementation and applications of PACE-HRH, a stochastic workload model of human resources for health

“…However, this assumes trends from the past will continue and that it is reasonable to extrapolate across contexts. Other models take a spreadsheet-like approach, tallying up workload and sometimes forecasting based on population growth, but this does not capture seasonal variation or stochasticity in workload (15). An additional limitation in existing tools is lack of user access: some of the models are proprietary, such as the model developed by CHAI (8), and local users cannot readily modify the model's structure to re ect their local context, nor can they add features.…”

The Role of the Temporary Contracting and Visiting Doctor Program in Supporting the Health System during and after COVID-19 Pandemic in Saudi Arabia

“…Health workers are essential for the functioning of the health systems, and their availability and equitable supply are vital to achieve universal access to healthcare at all levels ( 1 ). Those responsible of health planning and decision-making in any country should ensure the availability of an adequate supply of healthcare workers, with the proper skills, to deliver the required health services for the population ( 2 ). The adequate supply of health workforce should also be ensured for the effective response of health systems to disasters caused by natural or man-made hazards ( 1 ).…”

“…In Saudi Arabia (SA), the number of health workers has increased steadily over the past decade. The total number of health workers, of both Saudi and non-Saudi nationalities, increased by 54% from 303,578 in 2011 to 467,650 in 2019 ( 2 ). According to recent data, the density of healthcare workers(physicians and nurses) in Saudi Arabia is around 9 per 1000 population, which is more than the level required to manage the burden of disease in the country ( 2 ).…”

“…The total number of health workers, of both Saudi and non-Saudi nationalities, increased by 54% from 303,578 in 2011 to 467,650 in 2019 ( 2 ). According to recent data, the density of healthcare workers(physicians and nurses) in Saudi Arabia is around 9 per 1000 population, which is more than the level required to manage the burden of disease in the country ( 2 ). However, there are two factors that undermine the ability of the health system to preserve a sustainable supply of healthcare professionals in all regions of the country.…”