Abstract
Abstract
Background
System dynamics (SD) modelling can inform policy decisions under Thailand's Universal Health Coverage. We report on this thinking approach to Thailand's strategic health workforce planning for the next 20 years (2018–2037).
Methods
A series of group model building (GMB) sessions involving 110 participants from multi-sectors of Thailand's health systems was conducted in 2017 and 2018. We facilitated policymakers, administrators, practitioners and other stakeholders to co-create a causal loop diagram (CLD) representing a shared understanding of why the health workforce's demands and supplies in Thailand were mismatched. A stock and flow diagram (SFD) was also co-created for testing the consequences of policy options by simulation modelling.
Results
The simulation modelling found hospital utilisation created a vicious cycle of constantly increasing demands for hospital care and a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of ageing populations and prevalent chronic illness. Hence, shifting emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care, and end-of-life care can be more effective.
Conclusions
Our SD modelling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term.
Funder
Thailand's Ministry of Public Health
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Public Administration
Reference33 articles.
1. Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. Lancet. 2018;391:1205–23. https://doi.org/10.1016/S0140-6736(18)30198-3.
2. Wibulpolprasert S, Sirilak S, Ekachampaka P, Wattanamano N. Thailand Health Profile 2008–2010. Press TWVO of T, editor. Thail. Heal. Profile. Bangkok: Bureau of Policy and Strategy, Ministry of Public Health; 2011. http://www.moph.go.th/ops/health_50.
3. Office of the National Economic and Social Development Board. The Twelfth National Economic and Social Development Plan (2017–2021). Bangkok, Thailand; 2017. https://www.nesdc.go.th/nesdb_en/ewt_w3c/main.php?filename=develop_issue.
4. Campbell J, Buchan J, Cometto G, David B, Dussault G, Fogstad H, et al. Human resources for health and universal health coverage: fostering equity and effective coverage. Bull World Health Organ. Instituto de Cooperación Social Integrare, Calle Balmes 30, 3°-1, 08007 Barcelona, Spain. 2013;91:853–63. http://www.who.int/entity/bulletin/volumes/91/11/13-118729.pdf.
5. World Health Organization. Everybody business—strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva: The WHO Document Production Services, World Health Organization; 2007.
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献