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Learn more about In Review
Research
Theepakorn Jithitikulchai
Harvard T.H. Chan School of Public Health
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Public hospitals under the Office of Permanent Secretary, Ministry of Public Health have critical shortage in health workers. The area-based network consolidations of public hospitals should help to enhance capacity of the health system from allocation improvement in limited resources.
Methods
This study calculates the counterfactual simulations of area-based network allocations for health workforce in 10,500 public hospitals. The network consolidations at the sub-district, district, provincial, or health-region levels allow health workforce reallocation within local network areas. This study examines improvements in the allocative efficiency from the health workforce redistribution. The workload per worker is calculated from the output measured by numbers of outpatient and inpatient cases and the input measured by numbers of health workers. Both output and input are weighted with their economic values, controlled for heterogeneity by regression analysis. The weights assigned to each outpatient and inpatient case reflect the relative health system resources predicted for each discharge. Finally, this study compares the status quo and ex ante scenarios, as before and after network consolidations.
Results
Network consolidations of the primary-level hospitals within the same district could averagely reduce workload per worker by 14%. Another practical policy option is that consolidating similar hospital levels such as primary, first-level secondary, and mid-level secondary hospitals altogether within the same district could reduce the workload per worker by 17%.
Conclusion
This study illustrates improvement in allocative efficiency of health workforce in public hospitals from the area-based network consolidations. The results provide an insightful example of efficiency gains from reallocating medical workforce within the same local areas.
Keywords
health workforce, health resources, resource allocation, health catchment area, community health planning, community health network
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Mar, 2021
No community comments so far
Reviewer #2 agreed
On 29 Mar, 2021
Review #1 received
Received 29 Mar, 2021
Reviewer #1 agreed
On 15 Mar, 2021
Reviews received
Received 15 Mar, 2021
Reviewers invited
Invitations sent on 11 Mar, 2021
Submission checks complete
On 03 Mar, 2021
Editor invited
On 03 Mar, 2021
Editor assigned
On 01 Mar, 2021
First submitted
On 01 Mar, 2021
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
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This preprint is under consideration at Human Resources for Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Theepakorn Jithitikulchai
Harvard T.H. Chan School of Public Health
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Mar, 2021
No community comments so far
Reviewer #2 agreed
On 29 Mar, 2021
Review #1 received
Received 29 Mar, 2021
Reviewer #1 agreed
On 15 Mar, 2021
Reviews received
Received 15 Mar, 2021
Reviewers invited
Invitations sent on 11 Mar, 2021
Submission checks complete
On 03 Mar, 2021
Editor invited
On 03 Mar, 2021
Editor assigned
On 01 Mar, 2021
First submitted
On 01 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Public hospitals under the Office of Permanent Secretary, Ministry of Public Health have critical shortage in health workers. The area-based network consolidations of public hospitals should help to enhance capacity of the health system from allocation improvement in limited resources.
Methods
This study calculates the counterfactual simulations of area-based network allocations for health workforce in 10,500 public hospitals. The network consolidations at the sub-district, district, provincial, or health-region levels allow health workforce reallocation within local network areas. This study examines improvements in the allocative efficiency from the health workforce redistribution. The workload per worker is calculated from the output measured by numbers of outpatient and inpatient cases and the input measured by numbers of health workers. Both output and input are weighted with their economic values, controlled for heterogeneity by regression analysis. The weights assigned to each outpatient and inpatient case reflect the relative health system resources predicted for each discharge. Finally, this study compares the status quo and ex ante scenarios, as before and after network consolidations.
Results
Network consolidations of the primary-level hospitals within the same district could averagely reduce workload per worker by 14%. Another practical policy option is that consolidating similar hospital levels such as primary, first-level secondary, and mid-level secondary hospitals altogether within the same district could reduce the workload per worker by 17%.
Conclusion
This study illustrates improvement in allocative efficiency of health workforce in public hospitals from the area-based network consolidations. The results provide an insightful example of efficiency gains from reallocating medical workforce within the same local areas.
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