System dynamics modelling of health workforce planning to address future challenges of Thailand’s Universal Health Coverage

Human Resources for Health

Pard Teekasap¹  Nipaporn Urwannachotima²  Borwornsom Leerapan³  Khunjira Udomaksorn⁴  Aronrag Meeyai⁵  Thinakorn Noree⁶  Kwanpracha Chiangchaisakulthai⁶  Wararat Jaichuen⁶  Krisada Sawaengdee⁶ 

[1]Faculty of Business Administration, Stamford International University, Bangkok, Thailand

[2]Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand

[3]Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, Thailand

[4]Faculty of Pharmacy, Prince of Songkla University, Songkla, Thailand

[5]Faculty of Public Health, Mahidol University, Bangkok, Thailand

[6]Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK

[7]International Health Policy Program, Thailand (IHPP), Ministry of Public Health, Nonthaburi, Thailand

[8]Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand

关键词: Human resource for health;    Health workforce;    Strategic planning;    Care delivery models;    Health systems performance;    Group model building;    Causal loop diagram;    System dynamic modelling;   

DOI  :  10.1186/s12960-021-00572-5

来源: Springer

【 摘 要 】

BackgroundSystem dynamics (SD) modelling can inform policy decisions under Thailand's Universal Health Coverage. We report on this thinking approach to Thailand's strategic health workforce planning for the next 20 years (2018–2037).MethodsA series of group model building (GMB) sessions involving 110 participants from multi-sectors of Thailand's health systems was conducted in 2017 and 2018. We facilitated policymakers, administrators, practitioners and other stakeholders to co-create a causal loop diagram (CLD) representing a shared understanding of why the health workforce's demands and supplies in Thailand were mismatched. A stock and flow diagram (SFD) was also co-created for testing the consequences of policy options by simulation modelling.ResultsThe simulation modelling found hospital utilisation created a vicious cycle of constantly increasing demands for hospital care and a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of ageing populations and prevalent chronic illness. Hence, shifting emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care, and end-of-life care can be more effective.ConclusionsOur SD modelling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term.

【 授权许可】

CC BY