title: The construction of a decision tool to analyse local demand and local supply for GP care using a synthetic estimation model.
abstract: BACKGROUND
  This study addresses the growing academic and policy interest in the appropriate provision of local healthcare services to the healthcare needs of local populations to increase health status and decrease healthcare costs. However, for most local areas information on the demand for primary care and supply is missing. The research goal is to examine the construction of a decision tool which enables healthcare planners to analyse local supply and demand in order to arrive at a better match.
  
  
  METHODS
  National sample-based medical record data of general practitioners (GPs) were used to predict the local demand for GP care based on local populations using a synthetic estimation technique. Next, the surplus or deficit in local GP supply were calculated using the national GP registry. Subsequently, a dynamic internet tool was built to present demand, supply and the confrontation between supply and demand regarding GP care for local areas and their surroundings in the Netherlands.
  
  
  RESULTS
  Regression analysis showed a significant relationship between sociodemographic predictors of postcode areas and GP consultation time (F [14, 269,467] = 2,852.24; P <0.001). The statistical model could estimate GP consultation time for every postcode area with >1,000 inhabitants in the Netherlands covering 97% of the total population. Confronting these estimated demand figures with the actual GP supply resulted in the average GP workload and the number of full-time equivalent (FTE) GP too much/too few for local areas to cover the demand for GP care. An estimated shortage of one FTE GP or more was prevalent in about 19% of the postcode areas with >1,000 inhabitants if the surrounding postcode areas were taken into consideration. Underserved areas were mainly found in rural regions.
  
  
  CONCLUSIONS
  The constructed decision tool is freely accessible on the Internet and can be used as a starting point in the discussion on primary care service provision in local communities and it can make a considerable contribution to a primary care system which provides care when and where people need it.
authors.affiliation: Department of Primary Care Organization, NIVEL: Netherlands Institute for Health Service Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. w.ruizendaal@nivel.nl.
authors.forename: Willemijn A
authors.initials: WA
authors.lastname: de Graaf-Ruizendaal
authors.forename: Dinny H
authors.initials: DH
authors.lastname: de Bakker
mesh_terms: D003661:Decision Support Techniques; D005194:Family Practice; D058005:General Practitioners / Q000600:supply & distribution*; D006301:Health Services Needs and Demand; D006801:Humans; D015233:Models, Statistical; D009426:Netherlands; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012044:Regression Analysis; D000078329:Workforce; D016526:Workload