Rafiei Sima, Daneshvaran Arman, Abdollahzade Sina
Department of Healthcare Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Management, School of Management, Sharif University of Technology, Tehran, Iran.
J Educ Health Promot. 2018 Jan 10;7:16. doi: 10.4103/jehp.jehp_35_16. eCollection 2018.
Shortage of physicians particularly in specialty levels is considered as an important issue in Iran health system. Thus, in an uncertain environment, long-term planning is required for health professionals as a basic priority on a national scale.
This study aimed to estimate the number of required neurosurgeons using system dynamic modeling.
System dynamic modeling was applied to predict the gap between stock and number of required neurosurgeons in Iran up to 2020.
A supply and demand simulation model was constructed for neurosurgeons using system dynamic approach. The demand model included epidemiological, demographic, and utilization variables along with supply model-incorporated current stock of neurosurgeons and flow variables such as attrition, migration, and retirement rate.
Data were obtained from various governmental databases and were analyzed by Vensim PLE Version 3.0 to address the flow of health professionals, clinical infrastructure, population demographics, and disease prevalence during the time.
It was forecasted that shortage in number of neurosurgeons would disappear at 2020. The most dominant determinants on predicted number of neurosurgeons were the prevalence of neurosurgical diseases, the rate for service utilization, and medical capacity of the region.
Shortage of neurosurgeons in some areas of the country relates to maldistribution of the specialists. Accordingly, there is a need to reconsider the allocation system for health professionals within the country instead of increasing the overall number of acceptance quota in training positions.
医生短缺，尤其是专科医生短缺，被认为是伊朗卫生系统中的一个重要问题。因此，在不确定的环境中，需要在全国范围内将卫生专业人员的长期规划作为基本优先事项。
本研究旨在使用系统动力学建模来估计所需神经外科医生的数量。
应用系统动力学建模来预测到2020年伊朗神经外科医生存量与所需数量之间的差距。
使用系统动力学方法构建了神经外科医生的供需模拟模型。需求模型包括流行病学、人口统计学和利用变量，供应模型纳入了神经外科医生的当前存量以及诸如损耗、迁移和退休率等流量变量。
数据来自各种政府数据库，并通过Vensim PLE 3.0版进行分析，以处理卫生专业人员的流动、临床基础设施、人口统计学和疾病患病率随时间的变化情况。
预测到2020年神经外科医生数量短缺将消失。预测神经外科医生数量的最主要决定因素是神经外科疾病的患病率、服务利用率和该地区的医疗能力。
该国某些地区神经外科医生短缺与专科医生分布不均有关。因此，需要重新考虑国内卫生专业人员的分配系统，而不是增加培训岗位的总体录取配额。
