Measures of equity and efficiency in medical manpower planning. A prediction of internists needed in the Finnish national health service.
Several difficulties regarding manpower planning in health care based on need for service can be demonstrated. Easily obtainable utilisation numbers do not directly reflect demand or need for service, nor can they be used as an approximation of morbidity. Epidemiological studies, on the other hand, do not reveal "non-clinical" demand factors. Unmet demand cannot automatically be interpreted as undersupply or lack of resources. Planning according to predicted need has furthermore been severely handicapped by a nongrowing economy; it is rather asking for development through reallocation of resources. Consequently, another approach was chosen in this study - a prediction of internists needed in the Finnish national health service to ensure an equal supply and an efficient provision of services. Equity between regions was measured as number of specialists' positions, hospital admissions and out-patient visits per population. The number of admissions and visits per specialist's position was used as a measure of system efficiency. A density of specialists equal to the national mean in all regions would require a 21% increase in specialists' positions. A sensitivity analysis according to different levels of service supply as well as improved efficiency projected a 23-127% growth.
D005387:Finland; D005544:Forecasting; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006280:Health Workforce; D007388:Internal Medicine; D013222:State Medicine