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Michael Gyimesi

Publications and source records attributed to Michael Gyimesi.

2 recordsLinked to original sources

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

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.

stat.AP

Identification of gatekeeper diseases on the way to cardiovascular mortality

Multimorbidity, the co-occurrence of two or more chronic diseases such as diabetes, obesity or cardiovascular diseases in one patient, is a frequent phenomenon. To make care more efficient, it is of relevance to understand how different diseases condition each other over the life time of a patient. However, most of our current knowledge on such patient careers is either confined to narrow time spans or specific (sets of) diseases. Here, we present a population-wide analysis of long-term patient trajectories by clustering them according to their disease history observed over 17 years. When patients acquire new diseases, their cluster assignment might change. A health trajectory can then be described by a temporal sequence of disease clusters. From the transitions between clusters we construct an age-dependent multilayer network of disease clusters. Random walks on this multilayer network provide a more precise model for the time evolution of multimorbid health states when compared to models that cluster patients based on single diseases. Our results can be used to identify decisive events that potentially determine the future disease trajectory of a patient. We find that for elderly patients the cluster network consists of regions of low, medium and high in-hospital mortality. Diagnoses of diabetes and hypertension are found to strongly increase the likelihood for patients to subsequently move into the high-mortality region later in life.

physics.med-ph