Assessing the need for human resources in health: Nephrologist supply forecast in Uruguay
DOI:
https://doi.org/10.29193/RMU.38.3.7Keywords:
CHRONIC KIDNEY DISEASE, HUMAN RESOURCES FOR HEALTH, POPULATION HEALTH NEEDS, NEPHROLOGY, PLANNINGAbstract
Introduction: improving the health of populations by means of favoring universal access with equity requires the appropriate number and right distribution of professionals, according to the different health problems people face. Rigorous methodologies should include identification of health requirements in order to comply with this principle.
Objective: to estimate the demand for nephrologists in the Uruguayan population in 2020.
Method: a group of reference nephrologists - scholars or members of the scientific society - was formed to forecast the demand for these specialists. To that end they reviewed historical data and sources of this field of knowledge that have some connection with kidney diseases in the studied population. Subsequently, a number of assumptions and initial conditions were defined to conduct the study. The demand for nephrologists in Uruguay by 2020 was estimated for the whole country and by department, and it was expressed in absolute values and professional-to-population ratio. Alternative requirement scenarios were identified based on modifications to the initial conditions.
Results: the demand for nephrologists is between 139 and 192 professionals, which implies a 39 to 54 per 1 million inhabitants ratio.
Conclusions: this is the first one of this kind of studies conducted in Uruguay to report standards for nephrologists requirement in specialists per one million inhabitants, for different scenarios defined based on criteria that have been made explicit and backed.
References
2) Barber P, López-Valcárcel BG. Forecasting the need for medical specialists in Spain: application of a system dynamics model. Hum Resour Health 2010; 8(24):1-9. doi: 10.1186/1478-4491-8-24.
3) Roberfroid D, Leonard C, Stordeur S. Physician supply forecast: better than peering in a crystal ball? Hum Resour Health 2009; 7:10. doi: 10.1186/1478-4491-7-10.
4) Asamani JA, Christmals CD, Reitsma GM. Advancing the population needs-based health workforce planning methodology: a simulation tool for country application. Int J Environ Res Public Health 2021; 18(4):2113. doi: 10.3390/ijerph18042113.
5) Asamani JA, Christmal CD, Reitsma GM. The needs-based health workforce planning method: a systematic scoping review of analytical applications. Health Policy Plan 2021; 36(8):1325-43. doi: 10.1093/heapol/czab022.
6) Birch S, Kephart G, Murphy GT, O’Brien-Pallas L, Alder R, MacKenzie A. Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning. J Public Health Manag Pract 2009; 15(6 Suppl):S56-61. doi: 10.1097/PHH.0b013e3181b1ec0e.
7) Fakhri A, Seyedin H, Daviaud E. A combined approach for estimating health staff requirements. Iran J Public Health 2014; 43(1):107-15. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454024/ [Consulta: 18 febrero 2022].
8) Cavalleri F, Segura Á, Buglioli M, Riva J, Barber P. Modelo dinámico para proyectar la necesidad de recursos humanos en salud: anestesistas en Uruguay. Rev Salud Pública 2021; 23(6):1-9. doi: 10.15446/rsap.V23n6.90443.
9) Uruguay. Decreto 465/008. Aprobación de los programas integrales de salud y catálogo de prestaciones del Sistema Nacional Integrado de Salud. (Montevideo, 3 de octubre de 2008). Disponible en: http://www.impo.com.uy/bases/decretos/465-2008 [Consulta: 18 febrero 2022].
10) Newhouse J; Insurance Experiment Groop. Free for all?. London: Harvard University, 1996.
11) Barber Pérez P, González López-Valcárcel B. Oferta y necesidad de médicos especialistas en España 2006-2030. Las Palmas: Universidad de Las Palmas de Gran Canaria; 2007. 158 p. Disponible en: https://bit.ly/3G5gaRd [Consulta: 16 febrero 2022].
12) Barber Pérez P, González López-Valcárcel B. Estimación de oferta y demanda de médicos especialistas. España 2018-2030. Las Palmas: Universidad de Las Palmas de Gran Canaria, 2018. 168 p. Disponible en: https://bit.ly/2ZLFxI7 [Consulta: 16 febrero 2022].
13) Royal College of Physicians. Consultant physicians working with patients: the duties, responsibilities and practice of physicians in medicine. Revised 5th edition. London: Royal College of Physicians, 2013.
14) Cavalleri F, Bouchacourt JP, Noya B, Illescas L, Rodríguez A, Castromán P, et al. A 10 años de la emergencia sanitaria anestésico-quirúrgica en Uruguay. Comparación de los resultados de la oferta actual con la proyectada en 2011. Rev Méd Urug 2021; 37(2):e911. doi: 10.29193/RMU.37.2.12.
15) Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int 2021; 99(3S):S1-S87. doi: 10.1016/j.kint.2020.11.003.
16) Lorenzo Sellarés V, Luis Rodríguez D. Enfermedad renal crónica. Sociedad Española de Nefrología, 2021. Disponible en: https://www.nefrologiaaldia.org/136 [Consulta: 18 febrero 2022].
17) Sharif MU, Elsayed ME, Stack AG. The global nephrology workforce: emerging threats and potential solutions! Clin Kid J 2016; 9(1):11-22. doi: 10.1093/ckj/sfv111 Disponible en: https://academic.oup.com/ckj/article/9/1/11/2462384?login=false [Consulta: 18 febrero 2022].
18) Ortega F. Situación de la especialidad de Nefrología en relación a las necesidades de nefrólogos y a su formación. Nefrología 2008; 28(3):241-359. Disponible en: https://revistanefrologia.com/es-situacion-especialidad-nefrologia-relacion-necesidades-articulo-X021169950800587X [Consulta: 25 febrero 2022].
19) GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395(10225):709-33. doi: 10.1016/S0140-6736(20)30045-3.
20) Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol 2020; 16(10):573-85. doi: 10.1038/s41581-020-0315-4.
21) Silvariño R, Boggia J, Cavalleri F, Gadola L, Fernández-Ceán J, González F, et al. ¿A qué se dedica la nefrología? Apuntes y reflexiones sobre la misión de la especialidad, formación de posgrado, áreas de desempeño y forma de trabajo en Uruguay. Rev Méd Urug 2022; 38(1):e981. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-03902022000101981&lng=es&nrm=iso [Consulta: 25 febrero 2022].
22) Uruguay. Ministerio de Salud Pública. Nuevo régimen de trabajo médico. Texto ordenado del nuevo laudo vigente. (Segunda versión, 1º abril de 2018). Disponible en: https://www.gub.uy/ministerio-salud-publica/comunicacion/publicaciones/nuevo-regimen-trabajo-medico-texto-ordenado-del-laudo-vigente [Consulta: 25 febrero 2022].
23) Schwedt E, Solá L, Ríos P, Mazzuchi N. Guía clínica para identificación, evaluación y manejo del paciente con enfermedad renal crónica en el primer nivel de atención. Programa de Salud Renal. Montevideo: FNR, 2006. (Publicación Técnica, 2). Disponible en: http://www.fnr.gub.uy/sites/default/files/publicaciones/FNR_guia_renal_cronica.pdf [Consulta: 25 febrero 2022].
24) Sociedad Uruguaya de Nefrología. Comisión de Salud Renal. Programa de salud renal: Mejora de la calidad asistencial de pacientes con enfermedad renal crónica. Montevideo, 2006. Disponible en: https://es.slideshare.net/JuanVictorBricenoOrtiz/prog-salud-renal [Consulta: 25 febrero 2022].
25) Osman MA, Alrukhaimi M, Ashuntantang GE, Bellorin-Font E, Benghanem Gharbi M, Braam B, et al. Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system. Kidney Int Suppl(2011) 2018; 8(2):52-63. doi: 10.1016/j.kisu.2017.10.009.