BOOKS OF RtfiDIfGS - PAHO/WHO

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PHYSICIAN SUPPLY AND SURGICAL DEMAND FORECASTING
:he age-distribution of the population in Cuyahoga County in 1980 were not readily
vailable from any known source. Consequeutly, estimates were obtained by comparing
tlie population distributions of Cuyahoga County and the whole U.S.A. Data
;rere collected from [8].
Twvo types of projections from this report, namely Series B and Series E, were
rniployed. The basic difference between these two projections is due to the assumption
under Series B projections of an average of 3.1 children per female iin the popuistion
and for Series E, an average of 2.11 children per female. Employing these two
projections leads to two types of results for the expected number of surgical procedures
for botlh the male and female segments of the county.
Statistical tests were first applied to the null hypothesis: "Thic distribution of the
population of Cuyalioga County, by age and sex in 1970 was the same as for the U.S.
in 1970." The null hypothesis was accepted on the basis of Kolmogorov-Smirnov
Nonparametric test and Chi-Square Goodness of Fit test.
'lhe vectLmo p'" and p/ were calculated using relations (1) and (2), and lthey are
:hown in Table 3.
The total iiumber of surgical procedures in 1970 in Cuyahoga County for males Nias
51,199 and for females (including obstetrics) 96,229. Hence the total number of procedures
for both sexes was 147,428. The estimated demand for surgical procedures for
males in 1980 is 57,666 by Series B and 55,941 by Series E projections. Similarly, the
,stimated demand for surgical procedures for females in 1980 is 116,041 by Series B
and 114,606 by Series E. This estimation predicts an increase of from 9 to 13 percent
in the surgical procedures for males and an increase of froin 19 to 21 percent in surgical
aud obstetrical procedures required by females ia the county. hlie results of this
analysis also present data on the projected number of procedures for each surgical
category up to the year 19S0. These values are shown in Table 4.
Th'le models thus provide us with the demand figures for Surgical Proectlures for
cach category of surgery. While these figures are interesting in their own right, the
greater aim of this study wvas the derivation of the number of anesthetics rcquired by
the population in thc county in 1980. Consequently, to obtain this number, we proceed
as follow-s:
Let a¡ = the conversion factor giving the number of anesthetics required by the ith
category of surgery.
Rational estimates for the values of ai, i = 1, ... , 16, vwere obtained froni [21 and
are shown in Table 4. The total number of 132,575 anesthetics in 1970 was then computed.
According to [71, there were 149 anesthesiologists in Cuyahoga County in
1970. This implies that S90 anesthetics werc performed on the average by an anestliesiologist.
Using the above conversion factors and the precomputed projected number of surgical
procedures, the number of anesthetics estimated by Series B forecasts in 1980
is 156,227. Under these assuniptions and assuming identical workload in 1980 as in
1970, the estimated number of anesthesiologists NA demanded in 1980 i¡S given by
SA -Number of anesthetics in 19S0/
Number of anes thetics per anesthesiologist = 176.
Similarly the number of anesthetics estimated by Series E in 1980 is 154,824. -lence
the nu,L_ -:- f anesthesiologists demanded in 1980 is 174. Thus tlie assumlption of 3.1
children per female in 1980 as opposed to a figure of 2.1 accounts for a diffcrence of
two aunesthesiologists dem',rnled ini 1980 as provided by thcse niodels.