A System Dynamics Approach to Modeling the Interplay in Supply, Demand, Utilization and Need for the Primary Care Workforce
Year: 2023
Type: conference-paper
Abstract: Context: the U.S. healthcare system. Objective: To apply system dynamics methods to develop a new simulation model of the primary care workforce that explicitly captures causal feedback and delays in clinician workforce education, training and employment, as well as the gaps between those, population need, and healthcare demand and utilization. Study Design and Analysis: This study: (1) Engaged stakeholders to conceptualize workforce development, health policy, and population demographics, and to identify relevant datasets; (2) Estimated model parameters from healthcare workforce, utilization, population health, and population demographics data; (3) Developed system diagrams and simulation models to map and quantify the relevant feedback processes; and (4) Systematically documented model conceptualization, data collection, analysis, and validation results. Setting or Dataset: Secondary quantitative data from: AMA, MEPS, Census, AAMC, ACGME, ACS, NSSP. Population Studied: the U.S. primary care and specialty medical students, residents, and practicing clinicians, and the general U.S. population (including births, deaths, migration, and changing health status), from 2002 to 2019 and projected to 2034 and beyond. Intervention/Instrument: Created a multicomponent system dynamics model with an interactive user interface. Outcome Measures: Clinician supply (people, hours, full-time equivalents [FTE]) and the gaps between that and healthcare demand, utilization, and population need (hours, FTE). Results: We present key initial projection results, including comparison to historical data and other published projections. Projected scenarios include supply side changes to physician hours, retirement age, medical school, and graduate medical education (GME) slots; selection of primary care versus specialty residency; and Physician Assistant (PA) and advanced practice registered nurse (APRN) engagement, as well as changes in need and demand for health care. We also present key questions and insights generated from the model development process. Conclusions: This system dynamics approach allowed us to provide both a model to generate clinician workforce projections and an understanding of the web of causal processes underlying those projections to better identify effective policy levers and interventions.
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4388736003