Feil E C, Welch H G, Fisher E S
Department of Veterans Affairs Medical Center, White River Junction, VT 05009.
JAMA. 1993 May 26;269(20):2659-63.
To review the major forecasts of physician supply and physician requirements.
English-language medical literature on physician manpower published between 1980 and 1990, identified from journal articles selected through searches of the MEDLINE and Health Planning and Administration databases using the search formulations physician supply, health manpower--physicians, and physician manpower.
Sources were selected if they were repeatedly cited and provided quantitative projections.
Each study was reviewed for its quantitative projections and to identify its methodological assumptions.
All forecasts point to a steadily increasing physician supply and, with one exception, suggest that supply will exceed requirements in the year 2000. The estimates of physician supply across studies varied primarily because of differing assumptions about entrance rates into the profession and the size and clinical work load of specific categories of physicians: researchers, teachers, administrators, residents, and women. The estimates of physician requirements were more volatile because of differences in the basic approach and assumptions about future growth and market structure.
Even though the measurement of entrance and exit rates from the profession is a generally accepted approach to forecasting supply, apparently minor disagreements on assumptions create large discrepancies between forecasts over time. There is no accepted approach to forecasting physician requirements.
回顾医生供给和医生需求的主要预测。
1980年至1990年间发表的关于医生人力的英文医学文献，通过使用搜索词“医生供给”、“卫生人力——医生”和“医生人力”检索MEDLINE和卫生规划与管理数据库，从选定的期刊文章中识别出来。
如果文献被反复引用并提供了定量预测，则将其选为研究来源。
对每项研究的定量预测进行审查，并确定其方法学假设。
所有预测都表明医生供给将稳步增加，且除一项预测外，其他预测均表明到2000年供给将超过需求。各项研究中医生供给的估计值存在差异，主要是因为对进入该行业的比率以及特定类别医生（研究人员、教师、管理人员、住院医师和女性）的规模和临床工作量的假设不同。由于基本方法以及对未来增长和市场结构的假设存在差异，医生需求的估计值波动更大。
尽管衡量进入和退出该行业的比率是预测供给的一种普遍接受的方法，但随着时间的推移，假设上明显细微的分歧会导致预测之间出现巨大差异。目前尚无公认的预测医生需求的方法。
