Forecasting the Global Shortages of Physicians: An Economic- and Needs-Based Approach

Abstract

Objectives: An adequate supply of physicians is a key component for any health system. We assess the current global supply of physicians and estimate the future supply of, demand for, and need for physicians by WHO region to determine where likely shortages and surpluses will occur by 2015. Methods: Using World Bank data on physicians per capita from 1980-2001 for 158 countries of the world, we employ two different modelling approaches to estimating the future global supply of physicians. A needs-based model assesses the number of physicians per capita required to achieve 80% coverage of live births by skilled health care attendants in any given country. These estimates are then compared to those of an economic model which identifies the number of physicians likely to be demanded, based on the notion from previous research that economic growth is the best single predictor in growth in health care spending, and subsequently physician demand. Results: By 2015, the world supply of physicians appears to be in balance with projected demand. Because our measure of need — 80% of live births attended by a skilled health worker — reflects a relatively low level of health service provision that is met in all but the least developed countries, the needs-based estimate predicts a global surplus of physicians. However, on a regional basis, both our needs-based and demand-based estimates project shortages for many countries in Africa in 2015. In particular, some African countries will experience both a need and demand shortage, suggesting that these economies may not be able to support larger supplies despite the need for a larger workforce, possibly contributing to out-migration. Conclusion: Achievements in global health will entail policies geared toward increasing physician supplies in identified shortage regions, as well as addressing physician migration.