Volume 10, Issue 2 (Apr- June 2021)
JCHR 2021, 10(2): 136-149 |
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1- 1. Department of Economics, Faculty of Management and Human Science, Chabahar Maritime University, Chabahar, Iran
2- Department of Economics, Faculty of Management and Human Science, Chabahar Maritime University, Chabahar, Iran , siminghaderi@yahoo.com
2- Department of Economics, Faculty of Management and Human Science, Chabahar Maritime University, Chabahar, Iran , siminghaderi@yahoo.com
Abstract: (1539 Views)
Introduction: Due to the necessity of careful planning in the human capital of health and the effect of imbalance of general physician supply on economy and health status, this study aimed to estimate general practitioners' (GPs) demand and predict general practitioners’ shortage and surplus in Iran.
Method: This study was an analytical and applied study conducted at the national level for Iran in 2019 using ARIMA (5,1,1) method for projecting supply and Vector Error Correction (VEC) models for projecting demand with Gross Domestic Product (GDP), out-of-pocket, aging and hospital beds variables. Data were annual time series from 1991 to 2017, extracted from the statistical yearbooks issued by the Statistical Center of Iran and the World Bank database. The required models and tests were estimated by Eviews 10 software at a 0.05 significance level.
Results: The general practitioners’ elasticity to GDP, aging, and out-of-pocket were 0.33, 1.77, and -0.81, respectively. GDP per capita (0.11), aging (0.14), and the number of hospital beds (0.0007) had a positive impact, and out-of-pocket payments (-0.0001) had a negative impact on demand for GPs in Iran. Also, from 2018 to 2030, the mean GPs demand (0.23) was higher than the mean supply (0.20), and there was a shortage of GPs in these years (0.03).
Conclusion: Iran is facing a shortage of GPs by 2030. Therefore, there are suggested policies for increasing the admissions capacity at medical universities, maintaining and preventing the migration of physicians with appropriate incentives, establishing rules, and providing job satisfaction for physicians.
Method: This study was an analytical and applied study conducted at the national level for Iran in 2019 using ARIMA (5,1,1) method for projecting supply and Vector Error Correction (VEC) models for projecting demand with Gross Domestic Product (GDP), out-of-pocket, aging and hospital beds variables. Data were annual time series from 1991 to 2017, extracted from the statistical yearbooks issued by the Statistical Center of Iran and the World Bank database. The required models and tests were estimated by Eviews 10 software at a 0.05 significance level.
Results: The general practitioners’ elasticity to GDP, aging, and out-of-pocket were 0.33, 1.77, and -0.81, respectively. GDP per capita (0.11), aging (0.14), and the number of hospital beds (0.0007) had a positive impact, and out-of-pocket payments (-0.0001) had a negative impact on demand for GPs in Iran. Also, from 2018 to 2030, the mean GPs demand (0.23) was higher than the mean supply (0.20), and there was a shortage of GPs in these years (0.03).
Conclusion: Iran is facing a shortage of GPs by 2030. Therefore, there are suggested policies for increasing the admissions capacity at medical universities, maintaining and preventing the migration of physicians with appropriate incentives, establishing rules, and providing job satisfaction for physicians.
Review: Research |
Subject:
General
Received: 2020/07/2 | Accepted: 2021/03/20 | Published: 2021/07/1
Received: 2020/07/2 | Accepted: 2021/03/20 | Published: 2021/07/1
References
1. 1. Liu JX, Goryakin Y, Maeda A, et al. Global Health Workforce Labor Market Projections for 2030. Human resources for health. 2017;15(11):1-12. [DOI:10.1186/s12960-017-0187-2]
2. Shahraki M, Agheli L, Assari Arani A, et al. The relationship between mother's socioeconomic status and child health. Journal of Research and Health. 2018;8(2):143-51. [DOI:10.29252/jrh.8.2.143]
3. Scheffler RM, Arnold DR. Projecting shortages and surpluses of doctors and nurses in the OECD: what looms ahead. Health Economics, Policy and Law. 2018;14(2):274-90. [DOI:10.1017/S174413311700055X]
4. Sunaert P, Vandekerckhove M, Bastiaens H, et al. Why do GPs hesitate to refer diabetes patients to a self-management education program: a qualitative study. BMC Family Practice. 2011;12(1):1-11. [DOI:10.1186/1471-2296-12-94]
5. Shokri A, Akbari-Sari A, Bayat M, et al. Estimate General Practitioners Active Supply in Iran: Capture-Recapture Method for Three Data Sources. Iranian Journal of Public Health. 2019;48(12):2240-8. [DOI:10.18502/ijph.v48i12.3557]
6. Farzadi F, Mohammad K, Maftoun F, et al. General Practitioner Supply: Family Physician Program And Medical Workforce. Payesh. 2009;8(4):415-21.[Persian]
7. Mosadeghrad A, Jooya T. Factors influencing patient choice of a medical consultant in Tehran. Razi Journal of Medical Sciences. 2017; 24(160):62-72. [Persian].
8. Cooper RA, Getzen TE, Laud P. Economic expansion is a major determinant of physician supply and utilization. Health services research. 2003;38(2):675-96. [DOI:10.1111/1475-6773.00139]
9. Scheffler RM, Liu JX, Kinfu Y, et al. Forecasting the global shortage of physicians: an economic- and needs-based approach. Bulletin of the World Health Organization. 2008;86(7):516-23b. [DOI:10.2471/BLT.07.046474]
10. Chojnicki X, Moullan Y. Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages. Social science & medicine. 2018;200:227-37. [DOI:10.1016/j.socscimed.2018.01.038]
11. Nicholson S, Propper C. Medical Workforce. In: Pauly MV, McGuire TG, Barros P, editors. Handbook of Health Economics. 2. Holland: Elsevier.2011; 2: 873-925. [DOI:10.1016/B978-0-444-53592-4.00014-1]
12. Faulkner LR. Implications of a needs-based approach to estimating psychiatric workforce requirements. Academic Psychiatry. 2003; 27(4):241-6. [DOI:10.1176/appi.ap.27.4.241]
13. Dreesch N, Dolea C, Dal Poz MR, et al. An approach to estimating human resource requirements to achieve the Millennium Development Goals. Health policy and planning. 2005; 20(5):267-76. [DOI:10.1093/heapol/czi036]
14. Birch S, Kephart G, Murphy GT, et al. Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning. Journal of public health management and practice. 2009;15(6):S56-61. [DOI:10.1097/PHH.0b013e3181b1ec0e]
15. Bärnighausen T, Bloom DE. The Global Health Workforce. In: Glied S, Smith PC, editors. Health Econ. New York: Oxford University Press. 2012:486-529.
16. Fakhri A, Seyedin H, Daviaud E. A Combined Approach for Estimating Health Staff Requirements. Iran J Public Health. 2014;43(1):107-15.
17. Sargen M, Hooker RS, Cooper RA. Gaps in the supply of physicians, advance practice nurses, and physician assistants. Journal of the American College of Surgeons. 2011; 212(6):991-9. [DOI:10.1016/j.jamcollsurg.2011.03.005]
18. Ansah J, Koh V, de Korne D, et al. Comparing health workforce forecasting approaches for healthcare planning: The case for ophthalmologists. International Journal of Healthcare. 2017; 3(1):84-96. [DOI:10.5430/ijh.v3n1p84]
19. Dall T, Reynolds R, Jones K, et al. The 2019 update: the complexities of physician supply and demand: projections from 2017 to 2032. Association of American Medical Colleges. 2019:1-72.
20. Panahi H, Falahi F, Mohammadzadeh P, et al. Factors Influencing the Out -of-Pocket Payments by Patients in the Hospital in Tabriz-Iran. Health Information Management. 2014;11(2):199-207 [Persian].
21. Joyce CM, McNeil JJ, Stoelwinder JU. More doctors, but not enough: Australian medical workforce supply 2001-2012. The Medical Journal of Australia. 2006;184(9):441-6. [DOI:10.5694/j.1326-5377.2006.tb00315.x]
22. Scheffler RM. Health Labor Market Analyses in Low- and Middle-Income Countries: An Evidence-Based Approach. In: Scheffler RM, Herbst CH, Lemiere C, Campbell J, editors. Tools and Data Needs to Guide Evidence-Based Policy Making on Human Resources for Health. Washington, DC: World Bank. 2016:11-30. [DOI:10.1596/978-1-4648-0931-6_ch1]
23. Naicker S, Eastwood JB, Plange-Rhule J, et al. Shortage of healthcare workers in sub-Saharan Africa: a nephrological perspective. Clinical nephrology. 2010;74(1):129-33. [DOI:10.5414/CNP74S129]
24. world bank. Washington, D.C: world bank.2020 .Available from: https://data.worldbank.org/.
25. Bremer P. Forgone care and financial burden due to out-of-pocket payments within the German health care system. Health economics review. 2014;4(1):1-9. [DOI:10.1186/s13561-014-0036-0]
26. Roberfroid D, Leonard C, Stordeur S. Physician supply forecast: better than peering in a crystal ball?. Human resources for health. 2009;7(1):1-13. [DOI:10.1186/1478-4491-7-10]
27. Vujicic M, Shengelia B, Alfano M, et al. Physician shortages in rural Vietnam: using a labor market approach to inform policy. Social science & medicine (1982). 2011;73(7):970-7. [DOI:10.1016/j.socscimed.2011.06.010]
28. Birch S. Demand-based models and market failure in health care: projecting shortages and surpluses in doctors and nurses. Health Economics, Policy and Law. 2018;14(2):291-4. [DOI:10.1017/S1744133118000336]
29. Gujarati D. Econometrics by example. Second edition ed. London: Palgrave; 2017.
30. Johansen S. Statistical analysis of cointegration vectors. Journal of Economic Dynamics and Control. 1988;12(2-3):231-54. [DOI:10.1016/0165-1889(88)90041-3]
31. Johansen S. Determination of Cointegration Rank in the Presence of a Linear Trend. Oxford Bulletin of Economics and Statistics. 1992;54(3):383-97. [DOI:10.1111/j.1468-0084.1992.tb00008.x]
32. Shahraki M. Public and private health expenditure and life expectancy in Iran. Journal of the Iranian Institute for Health Sciences Research. 2019;18(3): 221-30[Persian].
33. Shahraki M, Ghaderi S. Investigating the Causal Relationship between Public Health Expenditure and Health Status; Panel Vector Auto-Regression Model. Health Research Journal. 2019;4(4): 220-6. [Persian] [DOI:10.29252/hrjbaq.4.4.220]
34. Statistical Center of Iran. Statistical Center of Iran. 2019. Available from: https://www.amar.org.ir/english.
35. Abbasi M, Hasoumi M, Mohamadi E, et al. Analysis of the relationship between distributions of health sector inputs and health outcomes in iran; using gini coefficient. Journal of Bioethics. 2014;4(12):65-79 .[Persian]
36. Honarmand R, Mozhdehifard M, Kavosi Z. Geographic distribution indices of general practitioners, midwives, pediatricians, and gynecologists in the public sector of Iran. Electron Physician. 2017;9(6):4584-9. [DOI:10.19082/4584]
37. Shahraki M, Ghaderi S. The Impact of medical Insurances on out-of-pocket payments among urban households in Iran: A Double-Sample selection Model. Journal of Health Administration. 2019;22(2):42-54. [Persian].
38. Shahraki M. Estimation of Supplementary Health Insurance Demand in Iranian Urban Household: Probit Model with Sample Selection. Iran Health Insurance Organization. 2019;2(1):10-6. [Persian].
39. Fletcher KE, Davis SQ, Underwood W, et al. Systematic review: effects of resident work hours on patient safety. Annals of Internal Medicine. 2004;141(11):851-7. [DOI:10.7326/0003-4819-141-11-200412070-00009]
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