BOOKS OF RtfiDIfGS - PAHO/WHO

MANAGEMENT SCIENCE
Vol. 19, No. 12, August, 1973
Prinled in U.S.A.
- 258 -
#13
PHYSICIAN SUPPLY AND SURGICAL DEMAND
FORECASTING: A REGIONAL MANPOWER STUDY*
A. RE[SMAN'*, B. V. DEAN**, A. O. ESOGB1UEt, V. A(OGARWAL**, V. KAUJALGI'*,
P. LEWY: AND J. S. GRAVENSTEIN**
Thie paper discuases the methoda and the results of a forecast for the demand
for operative and obstetrical procedures anid the supply of aniesthesiologista in
Cuyahoga County, Ohio. The techniques anid resulta of a ten-year forecast for the
deniand for and supply of aneathesiologists and auxiliary personnel in greater Cleveland
are dlicusaed. Several regression modele were used to forecast asupply based on
popuilation, number of physicians, and the income per capita. The demand models
wcre based onr population, age and sex distribution projections, and historical data
regarding operative and obstetrical procedures. The results of these "objective"
models were then compared to forecasts tunder tincertainty geznerated by a panel of
experts tU-ing the Delphi Method. Alternative states of healti care delivery were
investigarted and irnplications for future aimiastlhesiologist maanapower requiremenlts
detailed.
1. Introduction
It is gcnerally believed tlhat medical manlpower availability is a kecy element in the
never ending struggle to solve the nationi's healtl problems 113]. Matry regions are
facing severe shortages of health care professionals. There is general agreement that
persomnnl qualified to administer anesthesia are badly rnaldistributed; somce believe
tbat cven today many thousand anesthesia specialists are lacling. W\itlh the average
agc of anesthesiologists in thc nation bcing forty-five years and an attrition rate of
30% over thc next 10 years, a definition of what constitutes a properly balanced
supply and demand becomes important. In Cleveland n group of coneerned anesth(!siologists'
addressed itself to the problem of current shlortages in anesthesia manpower.
Under a grant from the U. S. Public Health Servicc, 2 the present authors in
cooperation with the Cleveland Committee on Anesthesia i\[anpower critically iavestigated
the current and future status of the anesthesia matnpo\we(r situation in the
county. Specifically, the problems of supply and demand of annestlcesiologists ia
Cuyalioga County, Olhio up to 19SO wcre investigated and models were developed:to
analyze these problems.
2. Supply Model
The number of anesthesiologists in Cuyahoga Courity in the year 190S can be forecasst
by considering different supply mnodels. These models are esseritially recgressiona
niodels. PaLranieters for tíhese models were, estima:ted usilg data fromt 1963(-1969. Ia
the study by Dougharty [4], a set of regression models for the supply of plhysicians in
the state of Arkansas was developed. The models proposed lhere correlate thle number
of phl sicir:is to the population and per capita income, wvith the data obtalined fronm the
* leceived Junre 1972; revised October 1972.
** Case WVestern Reberve University, Cleveland, Ohio 14106.
t Georgia Instittute of Technology, Atlanta, Georgia 30332.
lt alliol College, Oxford, I:nglarid.
' !)irect .,". Anaesslhesia D)epartmentsl in ninre major Cleveland lIospital:i.
sCuntra('t Nos. NIII 70-4033 a:id NIII 71-4022 (Anesthesi¢logy N:tlilpnwrei
Period Jai'uaary 1, 1971 to Marc'i 31, 1972.
Problerias) for thit
('opyriglt ) 1973. Tlhe InatitutL' 1ft M iarneuent heieuces