Family Physicians Working at Hospitals: A 20-Year Nationwide Trend Analysis in Taiwan

Family physicians play an essential role as gatekeepers in primary health care. However, most studies in the past focused on the geographic maldistribution of family physicians, and few studies focused on the distribution of family physicians between private practices and hospitals. This study aims to analyze the trends in practice locations of family physicians in Taiwan between 1999 and 2018, using the databases of the Taiwan Association of Family Medicine and Taiwan Medical Association. Although the annual number of physicians registered as family physicians had steadily increased from 1876 in 1999 to 3655 in 2018, the ratio of family physicians practicing in hospitals to total family physicians remained stable around 40% in the study period. Even after eliminating the trainees who were entirely registered at hospitals, the proportion of hospital-based family physicians still accounted for about one-third of the total in each year. In conclusion, family physicians had been continuously demanded by hospitals in Taiwan. If the supply of primary care-oriented family physicians is insufficient outside hospitals, health manpower planning would require urgent adjustments.

Universal Health Coverage in India: Where Rubber Hits the Road?

Poverty and healthcare issues are the most debatable topics today. Developing countries like India have as much as 45% of its population trapped in poverty because of various urgent healthcare needs. Universal health coverage (UHC) is a unique insurance system to provide financial protection to the marginalized groups of the country. It facilitates appropriate and immediate health needs, including required diagnostic, therapeutic and operational costs. However, UHC, a unique plan which focuses on the disadvantaged sections of the society, has some serious lacunae when it comes to its implementation in real life. This includes finances and human resources. Experts are reallocating adequate budgetary expenditure on healthcare issues, and in the meantime, a shortage of skilled health manpower is hunting down the UHC scheme in India. In recent times, different state governments are increasing budget allocation for the health sector. UHC is targeting low-income and poor families, forgetting the affordable and timely healthcare by way of improving services offered at the primary health centers and rapid expansion of the skilled health manpower across the country. UHC needs to focus on health paradigm systems, including improved healthcare-seeking behavior, nutrition, sanitation, potable water, reducing maternal and infant mortality, and dissemination of information of current technology to provide quality health services to the underserved and marginalized population of the country. These changes would symbolize a real way forward toward the immediate fulfillment of UHC goals for India.

Forecast and Analysis of China's Health Human Resources and Medical Higher Education Development Demand

Background: Statistics show that as of the end of December 2017, there were 11.749 million health workers and 898.82 million health technicians in China. In recent years, with the rapid development of the economy, the rapid expansion of the health manpower, which requires more scientific and rational health manpower forecasting, health manpower planning.It is important to strengthen and study the forecast of the future demand of the health workforce. Methods: On the basis of analyzing the current situation, changing trend and problems of China's human resources allocation and higher medical education, this study uses ARIMA model to forecast the demand of health workers in China from 2018 to 2024, and compares the difference smaller supply and demand of China's total health manpower.To determine the future development trend of China's health manpower, and finally explore the scientific and reasonable forecasting method of human resources for health. Results: China's total health manpower is relatively adequate, the proportion of medical care is unreasonable, medical staff is inadequate. The ARIMA model predicts an improvement in the inversion of health care in China and a continued increase in the demand for health care.By 2024, China's demand for health personnel will reach 17.4563 million, but the health manpower supply is still not keeping pace with the growth rate of demand, and the quantitative gap is still gradually widening in the short term, the gap between supply and demand in 2024 reached 1.4859 million people, medical and health institutions and medical education institutions are under greater pressure. Conclusion: In view of the forecast results of China's health human resources in this study, policy makers and health managers should pay more attention to and support the forecastplanning of health human resources, strengthen the government's macro-control, and actively solve the shortage of health manpower. Actively explore scientific models or methods for forecasting the demand of health workers, guide the planning practice of health manpower, guide the training of health personnel in colleges and universities, moderately expand the scale of medical education and training, and vigorously improve the quality of medical education.

Health Manpower Forecasting: A systematic Review for Models and Approaches

Background: An appropriate planning requires forecasting the demand and supply of health manpower in an accurate manner. Objectives: The paper objective was to review health manpower forecasting approaches and methods and propose the improvement features for effectiveness of health manpower planning. Data sources: A systematic review was conducted for studies published in English from 1970-2014 using Pub Med, Science Direct, Pro Quest, and Google Scholar databases. Study eligibility criteria: Review articles, qualitative studies, questionnaire driven surveys, retrospective and prospective studies describing or applying various types of forecasting approaches and methods in health manpower forecasting were included in the review. Data collection and study appraisal: Two reviewers (SR and MA) independently appraised the studies to identify relevant ones to be included in the review. Results: A total of 128 studies were included in the review. As a result, two main categories of approaches (conceptual and analytical) for health manpower forecasting were identified with their strengths and weaknesses. Conclusions: Future forecasting methods should benefit from advantages of current approaches and overcome some of their main limitations. Applying a method which incorporates a wide range of factors affecting supply and demand, facilitates the collection of good quality data, monitors changing trends over time, considers the uncertainty of health systems and has a dynamic approach is proposed as an improvement roadmap for future forecasting. Bangladesh Journal of Medical Science Vol.18(3) 2019 p.458-472