https://scholars.lib.ntu.edu.tw/handle/123456789/538298
標題: | Theoretical system dynamics modeling for Taiwan pediatric workforce in an era of national health insurance and low birth rates | 作者: | MEI-HWAN WU Yu J.-Y. CHUNG-HSING HUANG JIUN-YU YU |
公開日期: | 2013 | 卷: | 54 | 期: | 6 | 起(迄)頁: | 389-396 | 來源出版物: | Pediatrics and Neonatology | 摘要: | Background In an era of declining birth rates and a single-payer health care system, the pediatric workforce might overreact to its demands. System dynamics (SD) were therefore applied to establish models to predict the future need and demand for the pediatric workforce. Materials and methods Data of population and workforce were extracted from national databases and models developed using Vensim software. Results In the past decade, the child-to-pediatrician ratio correlated with infant mortality in Taiwan (p < 0.001, r2 = 0.88, child-to-pediatrician ratio = 146 + 354 × infant mortality/1000 live births). Currently, the child-to-pediatrician ratio is 1742:1. Using the Millennium Development Goals (2.437/1000 live births) for infant mortality, the child-to-pediatrician ratio was estimated as 1009:1. The pediatric population model incorporated the birth and mortality rates in each age category, accurately predicted population changes between 1974 and 2010, and projected a decreasing trend until 2017. The pediatric workforce model, which considered rates of enrollment, completion, certification, and retention, predicted a decrease in the supply of pediatricians in the mid-2010s that could be delayed by policy incentives. When targeting the base scenario, the model indicated that discrepancies between demands and supply of pediatricians would occur in the late 2010s toward 2020. When targeting the Millennium Development Goals scenario, however, the discrepancies would be consistent. Conclusion Effective SD models were developed for the population and health care workforce. The strengths of the SD models are derived from simulation, which is subject to influence from new policies. Policies can, therefore, be examined and intervened in a timely manner. Copyright ? 2013, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84889099058&doi=10.1016%2fj.pedneo.2013.04.010&partnerID=40&md5=43f42ebb702d0cb455152b36c0fc5720 https://scholars.lib.ntu.edu.tw/handle/123456789/538298 |
ISSN: | 1875-9572 | DOI: | 10.1016/j.pedneo.2013.04.010 | SDG/關鍵字: | article; birth rate; certification; child to pediatrician ratio; computer program; computer simulation; data base; health care manpower; human; infant mortality; live birth; mathematical model; national health insurance; pediatrician; population model; statistical parameters; Taiwan; pediatrics; system dynamics; workforce; Birth Rate; Databases, Factual; Female; Humans; Male; Middle Aged; Models, Theoretical; National Health Programs; Pediatrics; Taiwan |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。