Specialty Physician Requirement Projection Model : Lessons Learned from Developed Nations - โมเดลคาดการณ์ความต้องการแพทย์เฉพาะทางในประเทศพัฒนา

Abstract

         Lessons learned on specialty physicians requirement projection model from developed nations, focusing on their concepts, key success factors or limitations, could be the relevant background information for the development of a novel model that was appropriate and critical to the Thai context. This study demonstrated the experiences of 5 American models and an Australian one. The first one, Adjusted Needs model or GMENAC model (1981), defined the needs of physicians based on epidemiological conditions and basic needs of the nation. Whereby, three models were developed - Supply model, Graduate Medical Education (GME) model and Physician Manpower Requirements model. The second one, BHPr Physician Demand-Utilization model (1993), comprised a demand side on service utilization plus health insurance and a supply side on productivity of physicians by medical schools. The third one, Managed Care model (1997), had estimated the national requirement of physicians by extrapolation from the number of medical doctors working with Healthcare Maintenance Offices (HMOs). The fourth one, Trend model (1995), was based on analysis of long term trends on a macro scale. The fifth one, The Robert Graham Center’s Projection model (2004), predicted requirement of primary care physicians by working with the support of three models, namely, Supply/Demand model, Planning model, and Need model, using a massive database o of American Medical Association Physician Master Files. This databank system has been collecting data through the past hundred years with periodical surveys and verifications through telephone interviews. The sixth one, the Australian Medical Workforce Advisory Committee (AMWAC) Projection model (2003), had a combination of supply and needs projection employing 5 methods on needs analysis: models of care, needs-based, utilization based, effective care/ demand, and effective infrastructure. There were collections of medical specialists through two means: database of medical specialists identified by their code numbers and annual national surveys on physician (ongoing annually since 1993 with impressive 80 percent response rate). The study also gave preliminary recommendations for any upcoming Thai model.

Key words: health workforce projection model, manpower planning, physician requirements, specialty physician