General practitioner workforce planning: assessment of four policy directions.

Hdl Handle:
http://hdl.handle.net/10147/116311
Title:
General practitioner workforce planning: assessment of four policy directions.
Authors:
Teljeur, Conor; Thomas, Stephen; O'Kelly, Fergus D; O'Dowd, Tom
Affiliation:
Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, AMiNCH, Tallaght, Dublin, Ireland. teljeurc@tcd.ie
Citation:
General practitioner workforce planning: assessment of four policy directions. 2010, 10:148 BMC Health Serv Res
Journal:
BMC health services research
Issue Date:
2010
URI:
http://hdl.handle.net/10147/116311
DOI:
10.1186/1472-6963-10-148
PubMed ID:
20525163
Abstract:
BACKGROUND: Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. METHODS: Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. RESULTS: Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. CONCLUSIONS: A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations but may provide a rapid and effective response. Increased nurse substitution appears to offer the best long-term prospects of addressing GP shortages and presents the opportunity to reshape general practice to meet the demands of the future.
Item Type:
Article
Language:
en
Keywords:
GENERAL PRACTITIONER; PRIMARY CARE SERVICE
MeSH:
Aged; Female; Forecasting; Health Care Surveys; Health Services Needs and Demand; Humans; Ireland; Male; Middle Aged; Models, Theoretical; Physicians, Family; Planning Techniques; Policy Making; Stochastic Processes
ISSN:
1472-6963

Full metadata record

DC FieldValue Language
dc.contributor.authorTeljeur, Conoren
dc.contributor.authorThomas, Stephenen
dc.contributor.authorO'Kelly, Fergus Den
dc.contributor.authorO'Dowd, Tomen
dc.date.accessioned2010-11-25T10:56:23Z-
dc.date.available2010-11-25T10:56:23Z-
dc.date.issued2010-
dc.identifier.citationGeneral practitioner workforce planning: assessment of four policy directions. 2010, 10:148 BMC Health Serv Resen
dc.identifier.issn1472-6963-
dc.identifier.pmid20525163-
dc.identifier.doi10.1186/1472-6963-10-148-
dc.identifier.urihttp://hdl.handle.net/10147/116311-
dc.description.abstractBACKGROUND: Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. METHODS: Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. RESULTS: Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. CONCLUSIONS: A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations but may provide a rapid and effective response. Increased nurse substitution appears to offer the best long-term prospects of addressing GP shortages and presents the opportunity to reshape general practice to meet the demands of the future.-
dc.language.isoenen
dc.subjectGENERAL PRACTITIONERen
dc.subjectPRIMARY CARE SERVICEen
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshForecasting-
dc.subject.meshHealth Care Surveys-
dc.subject.meshHealth Services Needs and Demand-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshModels, Theoretical-
dc.subject.meshPhysicians, Family-
dc.subject.meshPlanning Techniques-
dc.subject.meshPolicy Making-
dc.subject.meshStochastic Processes-
dc.titleGeneral practitioner workforce planning: assessment of four policy directions.en
dc.typeArticleen
dc.contributor.departmentDepartment of Public Health and Primary Care, Trinity College Centre for Health Sciences, AMiNCH, Tallaght, Dublin, Ireland. teljeurc@tcd.ieen
dc.identifier.journalBMC health services researchen

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