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

Abstract

Background: Need and demand modeling is one of the conceptual approaches of health workforce planning. In many models of this field, “need” is not considered. Each country should model according to its context. Objectives: The present study aimed to design a need adjusted with demand model of the health workforce in the fields of specialties and subspecialties. Methods: Walker and Avant’s synthesis theory method was used for modeling in this study. The concepts of need and demand were chosen as the focal concepts. In addition, to find the components related to the concepts and the relationships between these components, the result of a previous systematic review and a supplementary study of viewpoints of research teams were used. In the last step, the graphic form of the model was presented. Results: The need-adjusted demand model was presented in this study. In this model, the types of flows were headcounts. Actual need, willingness, and ability to use health services were considered. Finally, the number of full-time equivalents of physicians was estimated. Conclusions: In this model, a series of main components that are headcounts and a series of influential factors that affect the main factors through rates were considered.

Health Workforce Planning: Designing a Specialty and Subspecialty Supply Model for Iran

“…In step 2, to identify factors related to the focal concept and the relationships between them, text reviews, observations, and opinions of researchers are used ( 24 ).To determine the associated factors and their relationships, a previous systematic review conducted by the researchers of the present study ( 8 ), a review of documents in the Secretariat of the University Development Council of the Ministry of Health and Medical Education of Iran(MOHME) ( 9 , 28 ), books and articles review( 11 , 29 - 33 ), regional reports of the World Health Organization ( 34 - 41 ) and the logical form of these relationships based on the opinion of researchers were taken into account. It should be noted that the members of the research team included the two former and current secretaries of the University Development Council of the Ministry of Health and Medical Education and colleagues of this center specialized in health workforce planning(including one Ph.D.in medical education and one general surgeon specialized in health workforce planning and researcher in this field), the former director of the Education Development Center of Ministry of Health and Medical Education and former research director of the National Agency of Strategic Research in Medical Education (NASR); these experts were policymakers in field of the health system and also were theorists in the field of medical education with prolonged engagement with the subject of the present study and with work and executive experience in this field.…”

“…Also, the duration of education to become a specialist or specialist doctor is very long between 11 and 17 years, which requires an abundant budget to be spent on their training. With proper planning in this area, it is possible to prevent the wastage of the budget for the training of the surplus physicians ( 5 - 8 ).…”

“…Forecasting the future health workforce depends on the selected forecasting model ( 12 ). factors, which are country-specific, include socioeconomic status ( 13 , 14 ), level of education ( 15 ), population age structure, age and sex distribution, ethnic distribution and educational pathway ( 8 ).…”

“…Modeling of human resources both on the supply side and on the need and demand side should be performed according to the requirements of each country, and there is no holistic model in the fields of specialties and subspecialties in Iran ( 27 ).…”

“…It is necessary to explain that the present study is part of a comprehensive health workforce planning project, for which the “need-adjusted demand model” has already been designed and published ( 27 ).…”