Tomblin Murphy Gail, MacKenzie Adrian, Alder Robert, Birch Stephen, Kephart George, O'Brien-Pallas Linda
Dalhousie University, Halifax, Nova Scotia, Canada, University of Toronto, Toronto, Ontario, Canada.
Policy Polit Nurs Pract. 2009 Nov;10(4):240-51. doi: 10.1177/1527154409358777.
Aging populations, limited budgets, changing public expectations, new technologies, and the emergence of new diseases create challenges for health care systems as ways to meet needs and protect, promote, and restore health are considered. Traditional planning methods for the professionals required to provide these services have given little consideration to changes in the needs of the populations they serve or to changes in the amount/types of services offered and the way they are delivered. In the absence of dynamic planning models that simulate alternative policies and test policy mixes for their relative effectiveness, planners have tended to rely on projecting prevailing or arbitrarily determined target provider-population ratios. A simulation model has been developed that addresses each of these shortcomings by simultaneously estimating the supply of and requirements for registered nurses based on the identification and interaction of the determinants. The model's use is illustrated using data for Nova Scotia, Canada.
人口老龄化、预算有限、公众期望不断变化、新技术以及新疾病的出现，给医疗保健系统带来了挑战，因为人们在思考满足需求以及保护、促进和恢复健康的方式。为提供这些服务所需的专业人员制定的传统规划方法，很少考虑到他们所服务人群需求的变化，或者所提供服务的数量/类型以及提供方式的变化。由于缺乏能够模拟替代政策并测试政策组合相对有效性的动态规划模型，规划者往往倾向于依靠预测现行或任意确定的目标提供者与人口的比率。现已开发出一种模拟模型，该模型通过基于各种决定因素的识别和相互作用，同时估计注册护士的供给和需求，来解决上述每一个缺点。文中使用加拿大新斯科舍省的数据说明了该模型的应用。
