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System Dynamics Modeling of Health Workforce Planning to Address Future Challenges of Thailand’s Universal Health Coverage
Borwornsom Leerapan
Mahidol University Faculty of Medicine Ramathibodi Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9381-1045
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: System dynamics modeling can inform policy decisions of healthcare reforms under Thailand’s Universal Health Coverage. We report on this thinking approach to Thailand’s strategic health workforce planning for the next 20 years.
Methods: A series of group model building sessions involving 110 participants from multi-sectors of Thailand’s health systems was conducted in 2017 and 2018. Policymakers, healthcare administrators, and practitioners were facilitated to co-create a causal loop diagram representing a shared understanding of why the demands and supplies of the health workforce in Thailand can be mismatched and a stock and flow diagrams for testing the consequences of policy options.
Results: Our simulation modeling found hospital utilizations created a vicious cycle of constantly increasing demands for hospital care, and hence a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of aging 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: The system dynamics modeling 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.
Keywords
human resource for health, health workforce, strategic planning, care models, health systems performance, group model building, causal loop diagram, system dynamic modeling
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Received 10 Feb, 2021
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Reviewer #1 agreed
On 03 Feb, 2021
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On 31 Jan, 2021
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On 31 Jan, 2021
Editor invited
On 31 Jan, 2021
Version 1
Posted 21 Sep, 2020
No comments provided
Editorial decision: Major revision
On 28 Dec, 2020
Review #2 received
Received 12 Dec, 2020
Reviewer #2 agreed
On 01 Dec, 2020
Reviewers invited
Invitations sent on 17 Nov, 2020
Reviewer #1 agreed
On 17 Nov, 2020
Review #1 received
Received 17 Nov, 2020
First submitted
On 16 Sep, 2020
Editor assigned
On 16 Sep, 2020
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On 15 Sep, 2020
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On 15 Sep, 2020
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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
System Dynamics Modeling of Health Workforce Planning to Address Future Challenges of Thailand’s Universal Health Coverage
Borwornsom Leerapan
Mahidol University Faculty of Medicine Ramathibodi Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9381-1045
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
No community comments so far
Review #1 received
Received 10 Feb, 2021
Reviewers invited
Invitations sent on 03 Feb, 2021
Reviewer #1 agreed
On 03 Feb, 2021
Editor assigned
On 31 Jan, 2021
Submission checks complete
On 31 Jan, 2021
Editor invited
On 31 Jan, 2021
Version 1
Posted 21 Sep, 2020
No comments provided
Editorial decision: Major revision
On 28 Dec, 2020
Review #2 received
Received 12 Dec, 2020
Reviewer #2 agreed
On 01 Dec, 2020
Reviewers invited
Invitations sent on 17 Nov, 2020
Reviewer #1 agreed
On 17 Nov, 2020
Review #1 received
Received 17 Nov, 2020
First submitted
On 16 Sep, 2020
Editor assigned
On 16 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 15 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: System dynamics modeling can inform policy decisions of healthcare reforms under Thailand’s Universal Health Coverage. We report on this thinking approach to Thailand’s strategic health workforce planning for the next 20 years.
Methods: A series of group model building sessions involving 110 participants from multi-sectors of Thailand’s health systems was conducted in 2017 and 2018. Policymakers, healthcare administrators, and practitioners were facilitated to co-create a causal loop diagram representing a shared understanding of why the demands and supplies of the health workforce in Thailand can be mismatched and a stock and flow diagrams for testing the consequences of policy options.
Results: Our simulation modeling found hospital utilizations created a vicious cycle of constantly increasing demands for hospital care, and hence a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of aging 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: The system dynamics modeling 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.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5