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Demand-based models and market failure in health care: projecting shortages and surpluses in doctors and nurses

  • Stephen Birch (a1)
Abstract

Models for projecting the demand for and supply of health care workers are generally based on objectives of meeting demands for health care and assumptions of status quo in all but the demographic characteristics of populations. These models fail to recognise that public intervention in health care systems arises from market failure in health care and the absence of an independent demand for health care. Hence projections of demand perpetuate inefficiencies in the form of overutilisation of services on the one hand and unmet needs for care on the other. In this paper the problems with basing workforce policy on projected demand are identified and the consequences for health care system sustainability explored. Integrated needs-based models are offered as alternative approaches that relate directly to the goals of publicly funded health care systems and represent an important element of promoting sustainability in those systems.

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Corresponding author
*Correspondence to: Stephen Birch, Director and Taylor Family Chair, Centre for the Business and Economics of Health, University of Queensland, Brisbane, QSD 4072, Australia. Email: Stephen.birch@uq.edu.au
References
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Basu, K Pak, M (2016) Will the needs-based planning of health human resources currently undertaken lead to excess supply and inefficiency? Health Economics 25, 101110.
Birch, S, Tomblin Murphy, G, McKenzie, A Cumming, J (2015) In place of fear: aligning health care planning with system objectives to achieve financial sustainability. Journal of Health Services Research and Policy 20, 109114.
Birch, S, Mason, T, Sutton, M Whittaker, W (2013) Not enough doctors or not enough needs? Refocusing health workforce planning from providers and services to populations and needs. Journal of Health Services Research and Policy 18, 107113.
Di Matteo, L (2010) The sustainability of public health expenditure: evidence from the Canadian federation. European Journal of Health Economics 11, 569584.
Di Matteo, L (2014) Physician numbers as a driver of provincial government health spending in Canadian health policy. Health Policy 115, 1835.
Mason, T, Sutton, M, Whittaker, W Birch, S (2015) Exploring the limitations of age-based models for health care planning. Social Science and Medicine 132, 1119.
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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
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