COMPARING APPROACHES TO HEALTH WORKFORCE FORECASTING. THE CASE OF EYE CARE WORKFORCE IN SINGAPORE
For a long time, much emphasis has been placed on the need for optimal allocation of human resources in the healthcare sector and this is not without reasons. Human resource is quintessential in this labour intensive industry and hence meticulous planning of the workforce for the efficient provision of healthcare is needed. The demand for healthcare services is expected to rise substantially with an aging population as studies have shown that the prevalence of chronic ailments increases with age. Thus, strategic health workforce policies have to be carefully tailored to meet future demands. The purpose of this paper is compare four different approaches (workforce-to-population, needs-based, utilization-based and integrated demand-supply) for forecasting health workforce.
Method(s):
Four approaches were explored by a continuous time compartment model with explicit workforce stocks based on the systems modelling methodology of system dynamics. The model consists of three modules: prevalence of eye disease, demand/utilization and workforce requirements. The Singapore Epidemiology of Eye Diseases study and Administrative patient visit data were used.
Result(s):
We found that each approach project different number of required ophthalmologists over time. However, needs-based approach tends to project the larger number of required ophthalmologists, with integrated demand-supply, utilization-based and workforce-to-population ratio approaches succeeding in a descending order. In addition, the projected number of ophthalmologists required under the workforce-to-population ratio approach was found to be significantly different from all the approach in the short, medium and long term. Nonetheless, the odds of projecting different number of ophthalmologists required when using the utilization-based and integrated approaches gets larger over time. Lastly, comparing needs-based and integrated demand-supply approaches, in the short to medium time frame, the projected number of ophthalmologists required was significantly different.
Conclusion(s):
The finding that health workforce forecasting under the approaches is likely to produce both significant differences and similarities over time has implications in the choice of health workforce forecasting approach; that is future health workforce forecast is reliant on the choice of forecasting approach. Nevertheless, the appropriateness of the forecasting approach depends on the changing characteristics of population to be served, the time frame of the forecast, how factors influencing utilization of care is expected to change over time, and how the productivity of the workforce is likely to change.