Anderson G F, Han K C, Miller R H, Johns M E
Center for Hospital Finance and Management, Baltimore, MD 21205, USA.
Health Serv Res. 1997 Jun;32(2):139-53.
To compare three methods of computing the national requirements for otolaryngologists in 1994 and 2010.
Three large HMOs, a Delphi panel, the Bureau of Health Professions (BHPr), and published sources.
Three established methods of computing requirements for otolaryngologists were compared: managed care, demand-utilization, and adjusted needs assessment. Under the managed care model, a published method based on reviewing staffing patterns in HMOs was modified to estimate the number of otolaryngologists. We obtained from BHPr estimates of work force projections from their demand model. To estimate the adjusted needs model, we convened a Delphi panel of otolaryngologists using the methodology developed by the Graduate Medical Education National Advisory Committee (GMENAC).
DATA COLLECTION/EXTRACTION METHODS: Not applicable.
Wide variation in the estimated number of otolaryngologists required occurred across the three methods. Within each model it was possible to alter the requirements for otolaryngologists significantly by changing one or more of the key assumptions. The managed care model has a potential to obtain the most reliable estimates because it reflects actual staffing patterns in institutions that are attempting to use physicians efficiently.
Estimates of work force requirements can vary considerably if one or more assumptions are changed. In order for the managed care approach to be useful for actual decision making concerning the appropriate number of otolaryngologists required, additional research on the methodology used to extrapolate the results to the general population is necessary.
比较三种计算1994年和2010年全国耳鼻喉科医生需求的方法。
三家大型健康维护组织、一个德尔菲专家小组、卫生职业局（BHPr）以及已发表的资料。
比较了三种既定的计算耳鼻喉科医生需求的方法：管理式医疗、需求利用和调整后的需求评估。在管理式医疗模式下，对一种基于审查健康维护组织人员配置模式的已发表方法进行了修改，以估计耳鼻喉科医生的数量。我们从BHPr获得了其需求模型的劳动力预测估计值。为了估计调整后的需求模型，我们使用研究生医学教育全国咨询委员会（GMENAC）开发的方法召集了一个耳鼻喉科医生德尔菲专家小组。
数据收集/提取方法：不适用。
三种方法估计所需耳鼻喉科医生的数量差异很大。在每个模型中，通过改变一个或多个关键假设，有可能显著改变对耳鼻喉科医生的需求。管理式医疗模式有潜力获得最可靠的估计值，因为它反映了试图有效利用医生的机构的实际人员配置模式。
如果改变一个或多个假设，劳动力需求的估计可能会有很大差异。为了使管理式医疗方法在实际决策中对所需耳鼻喉科医生的适当数量有用，有必要对用于将结果外推至一般人群的方法进行更多研究。
