A parameter-free population-dynamical approach to health workforce supply forecasting of EU countries

Abstract

Many countries faced challenges in their health workforce supply like impending retirement waves, negative population growth, or a suboptimal distribution of resources across medical sectors even before the pandemic struck. Current quantitative models are often of limited usability as they either require extensive individual-level data to be properly calibrated or (in the absence of such data) become too simplistic to capture key demographic changes or disruptive epidemiological shocks like the SARS-CoV-2 pandemic. We propose a novel population-dynamical and stock-flow-consistent approach to health workforce supply forecasting that is complex enough to address dynamically changing behaviors while requiring only publicly available timeseries data for complete calibration. We demonstrate the usefulness of this model by applying it to 21 European countries to forecast the supply of generalist and specialist physicians until 2040, as well as how Covid-related mortality and increased healthcare utilization might impact this supply. Compared to staffing levels required to keep the physician density constant at 2019 levels, we find that in many countries there is indeed a significant trend toward decreasing density for generalist physicians at the expense of increasing densities for specialists. The trends for specialists are exacerbated in many Southern and Eastern European countries by expectations of negative population growth. Compared to the expected demographic changes in the population and the health workforce, we expect a limited impact of Covid on these trends even under conservative modelling assumptions. It is of the utmost importance to devise tools for decision makers to influence the allocation and supply of physicians across fields and sectors to combat these imbalances.