The required number of physicians: is it an optimal figure?
Apart from the developing countries in which the number of physicians is extremely low, the number of physicians in the different countries shows a wide range even if it is comparing with the GDP or even with the number of nurses. According WHO data there are more than 500 physicians/100,000 inhabitants in Cuba and in Italy; more than 400 in Belarus and Norway, or in Spain and Georgia; more than 300 in 22 countries among them Belgium, France, Germany and Greece, Sweden, Switzerland, or Bulgaria, Czech, Hungary, Slovakia, Lithuania, etc. The number of doctors is below 300/100,000 inhabitants for example in such rich countries as the Netherlands, and the USA, and below 200 in the United Kingdom or in Japan. There is no correlation between the GDP and the number of doctors, as well as between the average life expectancy (or GBD, DALY, DALE) and the number of doctors. (On the other hand there is good correlation between GDP and life expectancy.) There is no correlation between GP-s and specialists, but it may be a weak correlation between the number of hospital beds and the number of doctors. It is difficult to find an optimal doctor/nurse ratio among the different countries; nevertheless the definition of "nurses" has a different meaning in the different countries. The burden of diseases, or the "patients" load" is also not an objective reference point, because the more the doctors, the more the patients. In the different countries there are different norms of the physicians' performances mainly decided by the health insurance funds. The different reimbursement systems, as the "per capita" at the GP-s, or the DRG at the hospital care, or the point-based remuneration at the specialist care are the real rate limiting factors for the number of physicians, which are not necessarily adequate to the professional requirements.
Forgacs
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Semmelweis University, Budapest, Hungary.
D003906:Developing Countries; D005062:European Union; D006280:Health Workforce / Q000706:statistics & numerical data*; D020380:Needs Assessment / Q000706:statistics & numerical data*; D010820:Physicians / Q000600:supply & distribution*