BOOKS OF RtfiDIfGS - PAHO/WHO

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PHYSICIAN SUPPLY AND SUIRGICAL DE.MAND FORECASTING 1353
4. Conclusions
Both the supply and demand models presented above are primarily projection
,dclIs and the results can thus be compared. The demand for anesthesiologists under
rreat practices has been predicted to be from 174 to 176 by 1980. The range for the
.,pply of anesthesiologists in 1980 has been estimated to be from 164 to 182. Tihe
;iults for the supply level are somewvhat less than the demand that is expected to
1jst for anesthesiologists in 19S0.
The main limitation of the above models is that they neglect the etíects of techno-
,qical, legal, ethical and economic changes. It is, however, conceivable that these
etors would influence the supply of anesthesiologists and the demand for surgical
:;*ccdures ald hlence the demand for anesthesiologists ini 1980.
To incorporate various states of nature that cuuld conceivably occur ten years
:.nce into the prediction for the desired level of anestlhesia personnel, another model
i iorecasting demand under uncertainty was constructed, which is reported in detail
,1)i}. In that model, the subjective opinions of a panel of cxperts were used. The
n;nel included individuals affiliated with a representative group of iistitutions or
.ganizations, and having expertise in all areas that have a bearing on the problem
n.der consideration. The panel was provided with factual data and information ob-
,ined from the supply models. Tlrough several successive rounds of a DI:LIHI
*.ercise, consensus of the experts in the health care area was reached on a set of
.iestions concerning the future. The questions were coacerned with the following:
:.e attrition rate among anriesthesiologists; the probabilities of occurrence of various
aures over the next decade iii regard to tihe quality of aeasthesia cure and the num-
:.r of anesthetics per capita; thec perceived requirements of anesthesia personnel
*ith the change in the quantity of anesthesia care assuming no change in the popula-
'.ju and the number of anesthetics per capita; and the possible uses of the new .class
anesthesia persorinnel currently in training at Case West&en Reserve University
::d elsewlhere. Based on the results of thce DELPHI certain predictions were made.
was observed that in 1980 there will be an estiniated need for about 50 per rent
:7,re anesthesiologists, about 50 per cent more anesthesia residents in training, and a
ficienit number of trained nonphysician personncl in anesthíesia comprising a work
't' of about 70 in 1980. Through the DELPHI exercise, the constraints thlat con-
.ibute to thegap between current and "ideal" nianpower levels in anesthesiology were
., identified and ranked in order of their importance.
The DELIPHI method predicted a demand for 19S0 of 35 anesthesiologists more than
' mraathematical projections. A high demand would exist for anesthesiologists if ali
mproved level of health care were provided by 1980. Thc DELPIII model considered
':i aspect explicitly anld in fact reaclied a consensus on the figure of 0.57 as the
:robability for improved quality of health care with 10 per cenit inere:ase i the
-umber of anesthetics per capita by 1980. The projectioin mnodel, on the otlher hand,
=ade the preilictions under the current state of health care delivery, hence its predie-
'ions are lower than those obtained through the' DELPHI.
Acxxs>, .. l;.%t:xNT. .. ThI e present work wasl stipported under cointract a gr.iit, nid iide.lo .vailavbI?
.:ughi N'iI 70-4033 :rild NIli 70-4002. The Ruthiors aire greatly indebted tu IDrs. J. P'otter, N.
-Piero, S. Katz, S. Ko'v:ac, II. Iretlinhmer, E. Malia, 13. S:nlkcy, J. Smart, J. Viljiern; all Inelil-
.t u lihe CleveImld C,ímilxittee on A':o^theslilogy .Manpowcer, aln to I)r. M. lRhteCn, frr thelir
lklatnee, cooperation, nnd nssistance i¡n c',ndcting this atudy.