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医生人力预测的方法学问题及政策影响

Methodological issues and policy implications of physician manpower forecasting.

作者信息

Sapir-Guha D

出版信息

Health Policy. 1985;4(3):177-98. doi: 10.1016/0168-8510(85)90034-x.

Abstract

Future physician supply is a matter of concern in most industrialized countries due to its impact on cost and quality of health care. Consequently, forecasting the number of physicians becomes an important research issue from both methodological and policy perspectives. This article presents a simple forecast model developed for the State of Wisconsin (U.S.A.), using the complex federal model of the U.S. Graduate Medical Education National Advisory Committee as a backdrop. In this context, the article discusses the main determinants of physician supply, such as mobility, retention, ageing and productivity. The methodological issues in the simple modelling of such phenomena are examined using the Wisconsin case as an empirical example. Finally, policy implications of planning physician supply with respect to projected demand for services, changes in reimbursement patterns and productivity are discussed along with some of the recommendations actually made to the Wisconsin Legislature.

摘要

由于对医疗保健成本和质量的影响,未来医生供应在大多数工业化国家都是一个备受关注的问题。因此,从方法学和政策角度来看,预测医生数量成为一个重要的研究课题。本文以美国研究生医学教育国家咨询委员会的复杂联邦模型为背景,介绍了为美国威斯康星州开发的一个简单预测模型。在此背景下,本文讨论了医生供应的主要决定因素,如流动性、留用率、老龄化和生产率。以威斯康星州为例进行实证分析,研究了对此类现象进行简单建模时的方法学问题。最后,讨论了根据预计的服务需求、报销模式变化和生产率来规划医生供应的政策影响,以及实际向威斯康星州立法机构提出的一些建议。

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