November 11 th 2013 Healthcare Manpower Planning and Projection Pre‐disposing characteristics 1. Age‐sex group 2. Education 3. Household income per capita 4. Economically active 5. Behavioral risk factor: smoking status Enabling resources 1. Self‐purchased insurance (e.g. Private insurance, Health Protection Scheme) 2. Employment‐based medical benefits 3. CSSA Conceptual demand model for doctors Total population to be served Conversion into FTEs Conversion into service utilization Service utilization Projected number of FTEs Resident population Non‐resident population (e.g. medical tourism) Need 1. Self‐perceived health status 2. Doctor‐diagnosed chronic conditions 2 LC Paper No. CB(2)260/13-14(01)
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
November 11th 2013
Healthcare Manpower Planning and Projection
Pre‐disposing characteristics1. Age‐sex group2. Education3. Household income per capita4. Economically active5. Behavioral risk factor: smoking status
Enabling resources1. Self‐purchased insurance (e.g. Private insurance, Health Protection Scheme)2. Employment‐based medical benefits3. CSSA
Conceptual demand model for doctors
Total population to be served Conversion into FTEs
Conversion into service utilization
Service utilization
Projected number of FTEs
Residentpopulation
Non‐resident population(e.g. medical tourism)
Need1. Self‐perceived health status2. Doctor‐diagnosed chronic conditions
2
LC Paper No. CB(2)260/13-14(01)
Pre‐disposing characteristics1. Age‐sex group2. Education3. Household income per capita4. Economically active5. Behavioral risk factor: smoking status
Enabling resources1. Self‐purchased insurance (e.g. Private insurance, Health Protection Scheme)2. Employment‐based medical benefits3. CSSA
Conceptual demand model for doctors
Total population to be served Conversion into FTEs
Conversion into service utilization
Service utilization
Projected number of FTEs
Residentpopulation
Non‐resident population(e.g. medical tourism)
Need1. Self‐perceived health status2. Doctor‐diagnosed chronic conditions
Productivity change
Technologydiffusion Complementarity/ Substitution
(between health worker type)
EXTERNALITIES3
Pre‐disposing characteristics1. Age‐sex group2. Education3. Household income per capita4. Economically active5. Behavioral risk factor: smoking status
Enabling resources1. Self‐purchased insurance (e.g. Private insurance, Health Protection Scheme)2. Employment‐based medical benefits3. CSSA
Conceptual demand model for doctors
Total population to be served Conversion into FTEs
Conversion into service utilization
Service utilization
Projected number of FTEs
Residentpopulation
Non‐resident population(e.g. medical tourism)
(Inpatient)
1. Total number of discharges2. Total number of bed‐days(stratified by DRG and by service sector)
Service utilization
Need1. Self‐perceived health status2. Doctor‐diagnosed chronic conditions
Productivity change
Technologydiffusion Complementarity/ Substitution
(between health worker type)
EXTERNALITIES4
Pre‐disposing characteristics1. Age‐sex group2. Education3. Household income per capita4. Economically active5. Behavioral risk factor: smoking status
Enabling resources1. Self‐purchased insurance (e.g. Private insurance, Health Protection Scheme)2. Employment‐based medical benefits3. CSSA
Conceptual demand model for doctors
Total population to be served Conversion into FTEs
Conversion into service utilization Projected number
of FTEs
Residentpopulation
Non‐resident population(e.g. medical tourism)
Total number of visits(stratified by specialty and
by service sector)
Service utilization
(Outpatient)
Need1. Self‐perceived health status2. Doctor‐diagnosed chronic conditions
Productivity change
Technologydiffusion Complementarity/ Substitution
(between health worker type)
EXTERNALITIES5
Conceptual supply model for doctors
Total number ofregistrants
Clinically inactive1. No longer in medical practice but not retired2. Natural attrition / retirement3. Otherwise deregistratedNewly eligible
registrants
Renewal proportion
Conversion into number of clinically active doctors
Conversion into FTEs
Number of clinically active registrants(stratified by specialty and by service sector)
Projected number of FTEs
Non‐local graduates
Local graduates
Pre‐existing registrants
Workforce participation rate1. Female‐male ratio2. Preference for part‐time work otherwise
(likely age‐dependent)
6
Conceptual supply model for doctors
Total number ofregistrants
Clinically inactive1. No longer in medical practice but not retired2. Natural attrition / retirement3. Otherwise deregisteredNewly eligible
registrants
Renewal proportion
Conversion into number of clinically active doctors
Conversion into FTEs
Number of clinically active registrants(stratified by specialty and by service sector)
Projected number of FTEs
Non‐local graduates
Local graduates
Pre‐existing registrants
Workforce participation rate1. Female‐male ratio2. Preference for part‐time work otherwise
(likely age‐dependent)
Standard working hoursand/or other overarching
policy changes
Differential capacity and work pattern by service sector
EXTERNALITIES7
2013 2014
Pre-existing registrants Newly eligible registrants
Registered doctor
Clinically inactive Clinically active
FTEs
2013 2014
Pre-existing registrants Newly eligible registrants
Registered doctor
Clinically inactive Clinically active
Pre-existing registrants
FTEs
2013 2014
Pre-existing registrants Newly eligible registrants
Registered doctor
Clinically inactive Clinically active
Pre-existing registrants Newly eligible registrants
Registered doctor
Clinically inactive Clinically active
FTEs FTEs
Demand
2014 2015 20162013
Supply
FTE
11
Approach Concept Basis Criticisms Application
Need-based Socially optimal number of doctors
• Disease incidence• Doctor encounters• Time/pat encounter• Time in patient
care/year
• Lack efficacy and efficiency data
• No technological change• Assumes resources by
need
• RAND (ArchOpthalmol 1998)
• GMENAC (1981)
Demand / utilisation-based
Number likely to employ
• Current utilisationpatterns
• Estimates of change in demographics and demand
• Empirical analysis
• Current inequities carried forward
• Assumes all care useful• No non-curative service• No change in care
modality
• RAND (J B & Joint Surg 1998)
• Health WorkforceAustralia (NHWT 2010)
Benchmarking Defined standard of care
• Doctor/pop ratio • Assumes efficient mix and number
• Assumes no diff in health care sys
• No diffs in roles (e.g. GP/FM)
• Weiner (1994)• Weiner (2004)
Trend analysis Historicaltrends
• Aggregate-level, time-series data
• Estimate doctor/pop/capita, GDP, pop growth and ageing
• Assume supply = demand
• Assume more health care only limited by willingness to pay
• Cooper (HealthAffairs 2002)
HRSA (2008)
12
Related Documents
