Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. birch@mcmaster
J Public Health Manag Pract. 2009 Nov;15(6 Suppl):S56-61. doi: 10.1097/PHH.0b013e3181b1ec0e.
Health human resources planning is generally based on estimating the effects of demographic change on the supply of and requirements for healthcare services. In this article, we develop and apply an extended analytical framework that incorporates explicitly population health needs, levels of service to respond to health needs, and provider productivity as additional variables in determining the future requirements for the levels and mix of healthcare providers. Because the model derives requirements for providers directly from the requirements for services, it can be applied to a wide range of different provider types and practice structures including the public health workforce. By identifying the separate determinants of provider requirements, the analytical framework avoids the "illusions of necessity" that have generated continuous increases in provider requirements. Moreover, the framework enables policy makers to evaluate the basis of, and justification for, increases in the numbers of provider and increases in education and training programs as a method of increasing supply. A broad range of policy instruments is identified for responding to gaps between estimated future requirements for care and the estimated future capacity of the healthcare workforce.
卫生人力资源规划通常基于估计人口变化对医疗服务供应和需求的影响。在本文中，我们开发并应用了一个扩展的分析框架，将明确的人口健康需求、满足健康需求的服务水平以及提供者生产力作为确定未来医疗保健提供者的水平和组合的额外变量。由于该模型直接从服务需求中推导出对提供者的需求，因此它可以应用于广泛的不同提供者类型和实践结构，包括公共卫生劳动力。通过确定提供者需求的单独决定因素，分析框架避免了产生提供者需求持续增加的“必要性错觉”。此外，该框架使政策制定者能够评估增加提供者数量和增加教育和培训计划作为增加供应的方法的基础和理由。确定了广泛的政策手段来应对估计的未来护理需求与医疗保健劳动力未来能力之间的差距。
