School of Public Health,University of California,Berkeley,CA,USA.
Health Econ Policy Law. 2019 Apr;14(2):274-290. doi: 10.1017/S174413311700055X. Epub 2018 Jan 23.
There is little debate that the health workforce is a key component of the health care system. Since the training of doctors and nurses takes several years, and the building of new schools even longer, projections are needed to allow for the development of health workforce policies. Our work develops a projection model for the demand of doctors and nurses by Organisation for Economic Co-operation and Development (OECD) countries in the year 2030. The model is based on a country's demand for health services, which includes the following factors: per capita income, out-of-pocket health expenditures and the ageing of its population. The supply of doctors and nurses is projected using country-specific autoregressive integrated moving average models. Our work shows how dramatic imbalances in the number of doctors and nurses will be in OECD countries should current trends continue. For each country in the OECD with sufficient data, we report its demand, supply and shortage or surplus of doctors and nurses for 2030. We project a shortage of nearly 400,000 doctors across 32 OECD countries and shortage of nearly 2.5 million nurses across 23 OECD countries in 2030. We discuss the results and suggest policies that address the shortages.
几乎没有人会怀疑卫生人力是医疗保健系统的关键组成部分。由于医生和护士的培训需要数年时间，而新学校的建设则需要更长时间，因此需要进行预测，以便制定卫生人力政策。我们的工作为经合组织国家（OECD） 2030 年医生和护士的需求制定了一个预测模型。该模型基于一个国家对卫生服务的需求，其中包括以下因素：人均收入、自付医疗支出和人口老龄化。医生和护士的供应则使用特定国家的自回归综合移动平均模型进行预测。我们的工作表明，如果当前的趋势继续下去，经合组织国家的医生和护士人数将出现多么严重的失衡。对于经合组织中每个数据充足的国家，我们报告了其 2030 年医生和护士的需求、供应以及短缺或过剩情况。我们预测，在 32 个经合组织国家中，医生短缺近 40 万，在 23 个经合组织国家中，护士短缺近 250 万。我们讨论了结果并提出了一些解决短缺问题的政策建议。
