University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, 35017 Las Palmas de G,C,, Canary Islands, Spain.
Hum Resour Health. 2010 Oct 29;8:24. doi: 10.1186/1478-4491-8-24.
Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities.
We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method.
In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology.
The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America.
在短短几年内，西班牙的医生人数从过剩转为短缺。中长期卫生专业人员规划已成为卫生当局的当务之急。
我们使用系统动力学为 43 个医学专业创建了一个供需/需求模拟模型。该模型包括人口统计学、教育和劳动力市场变量。定义了几种方案。可以将卫生规划者可控制的变量设置为参数，以模拟不同的方案。该模型计算供应和短缺或过剩。专家使用 Delphi 方法确定每 1000 名居民所需的专家比例。
在人口增长率适中的基线模型情景下，医学专家的短缺将从目前的 2%（2800 名专家）增加到 2025 年的 14.3%（近 21000 名）。中期短缺最严重的专业是麻醉学、骨科和创伤外科、小儿外科、整形美容和修复外科、家庭和社区医学、儿科、放射学和泌尿科。
该模型表明需要增加医学院的招生人数。培训课程应重新设计，以促进专业之间的流动性。与此同时，需要通过来自欧盟新成员国和拉丁美洲的医生移民来增加短期供应的灵活性。
