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Table 1 Overview of forecasting approaches

From: Physician supply forecast: better than peering in a crystal ball?

Forecast strategy Concepts Strengths Limitations Countries
Supply model To project the number of physicians required to match the current services given the likely changes in the profession (age, feminization, etc...) • Can project physician numbers at 10–15 years with accuracy (?) • Perpetuates current physician-to-population ratio assumed to be adequate • Does not consider the evolution of the care demand USA [1317] Australia [18]* Nova Scotia, Canada [21]
Demand model To project the number of physicians required to match the current services given the likely changes in the demand (mainly population ageing and GDP growth) • Can anticipate changes in health practices (e.g. new surgical techniques or drugs) and in the health system • Perpetuates current utilization of services (SID, inappropriate services not addressed) • Assumes that MDs are the main actors and that any care is useful • Does not consider the demand for non curative services (prevention, research) and future trends • Requires huge amounts of data USA [14, 3133] Canada [10, 11, 26]
Needs-based model To project the number of physicians required to provide appropriate health care to the future population • Rely on a normative approach, i.e. can avoid the perpetuation of existing inequities and inefficiencies • Can include unmet needs in the estimation process • Requires detailed knowledge of the efficacy of individual medical services for specific conditions • Does not account for technological developments and changes in the organization of health services • The assumption that health care resources will be used in accordance with relative levels of need is not necessarily verified • Ignores the question of the efficiency in the allocation of resources between different sectors of the society USA [33, 36] Ontario, Canada [10, 11, 50] Australia [30]
Benchmarking To refer to a current best estimate of a reasonable physician workforce • Realistic • Is valid only if communities and health plans are comparable, i.e. adjusted for key demographic, health and health system parameters • Often does not document the extrapolation methodology sufficiently (e.g. unclear criteria for selecting the reference) USA [13, 33, 37, 40] Australia [30, 39]
  1. *: stochastic simulation