Department of Communication and Economics, University of Modena and Reggio Emilia, Viale Allegri 9, 42121, Reggio Emilia, Italy.
Department of Economics - Marco Biagi, University of Modena and Reggio Emilia, Via Berengario 51, 41121, Modena, Italy.
BMC Res Notes. 2023 May 21;16(1):84. doi: 10.1186/s13104-023-06353-8.
Physician density is a crucial element of a well-functioning health system. Previous research has investigated factors affecting country-level physician supply. To date, however, no evidence has been provided about the patterns of convergence in physician density among countries. This paper thus tested club convergence in physician density in 204 countries worldwide from 1990 to 2019. A nonlinear time-varying factor model was adopted to identify potential clubs, wherein groups of countries tend to converge towards the same level of physician density. Our primary purpose was to document the potential long-lasting disparity in future global physician distribution.
Despite physician density increasing in all regions globally from 1990 to 2019, we found no evidence in favor of the hypothesis of global convergence. Conversely, the clustering algorithm successfully identified three main patterns (i.e., three final clubs). With few exceptions, the results indicated an uneven physician distribution between the majority of North and Sub-Saharan African countries (where physician density would remain well below the estimated threshold of at least 70% of the Universal Health Coverage Services Index) and the rest of the world. These findings support the WHO's global strategy to reverse the chronic under-investment in human resources for health.
医师密度是一个运作良好的卫生系统的关键要素。先前的研究已经调查了影响国家一级医师供应的因素。然而，迄今为止，尚无证据表明各国之间医师密度的趋同模式。因此，本文在 1990 年至 2019 年间，测试了全球 204 个国家的医师密度俱乐部趋同现象。采用非线性时变因素模型来识别潜在的俱乐部，其中一些国家群体趋向于朝着相同的医师密度水平收敛。我们的主要目的是记录未来全球医师分布中潜在的持久差距。
尽管全球各地区的医师密度从 1990 年到 2019 年都有所增加，但我们没有发现支持全球趋同假设的证据。相反，聚类算法成功地识别了三个主要模式（即三个最终俱乐部）。除了少数例外，结果表明，在大多数北非和撒哈拉以南非洲国家（其医师密度将远远低于全民健康覆盖服务指数至少 70%的估计阈值）与世界其他地区之间，医师分布不均。这些发现支持世卫组织扭转对人力资源投资不足的全球战略。
