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. 2010 Oct 29:8:24.
doi: 10.1186/1478-4491-8-24.

Forecasting the need for medical specialists in Spain: application of a system dynamics model

Patricia Barber  1 , Beatriz González López-Valcárcel
Affiliations

Forecasting the need for medical specialists in Spain: application of a system dynamics model

Patricia Barber et al. Hum Resour Health. .

Abstract

Background: Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities.

Methods: We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method.

Results: In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology.

Conclusions: The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America.

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Figures

Figure 1
Figure 1
Illustration of the elements of system dynamics model. A simple model of physician workforce.
Figure 2
Figure 2
Stock and flow diagrams. Submodel of the supply of medical specialists 2008-2025. The number of doctors of each sex in each one of the 47 specialties depends on the new arrivals to the market (inmigration, training) and on the exits (retirements, drop-outs, mortality). In each step of the simulation the model shifts the medical population one year ahead, with 36 age-sex intervals (30 to 65 years of age). Age-sex pyramids for each specialty and year in the time horizon 2008-2025 are calculated.
Figure 3
Figure 3
Summarized model output up to 2025 for one specialty (allergists).
See this image and copyright information in PMC

References

    1. Simoens S, Hurst J. The Supply of Physician Services in OECD Countries. OCDE Working Papers. 2006;21 full_text.
    1. World Health Organization, WHO. The world health report 2006. Working together for health. 2007. - PubMed
    1. European Union Green Paper on the European Workforce for Health. COM (2008) 725/3. Brussels. 2009.
    1. European Union Research Project. PROMeTHEUS, Health Professional Mobility in the European Union Study. http://www.euro.who.int/observatory/Studies/20090211_1;
    1. Gonzalez Lopez-Valcarcel B, Barber P. Oferta y necesidad de médicos especialistas en España 2006-2030. Madrid: Ministerio de Sanidad y Consumo; 2007.

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