Table 4

Need/demand and supply factors identified from systematic literature reviews of workforce studies in other medical fields than rheumatology

Factors of need/demand and supply that were discussed in relation to workforce modelling processStudies discussing the factor
Demand/need factors
 Use patterns, market factors (eg, access to services and preferences of health consumers), insurance coverage6 studies27 29 31 32 34 35
 Morbidity, mortality, incidence and severity, degree of need (dependency-acuity method)6 studies27 28 32–35
 Population growth, ageing7 studies27 30–35
 Desirable service volume (estimated demand for care), in relation to population health referral volume2 studies27 30
 Changes in guidelines that can help to anticipate increase or decrease in need/demand1 study27
 Income and education level, deprivation2 studies28 34
 Geographical distribution, travel distances2 studies28 30
 Adjustments for market inefficiencies1 1 study32
 Technology development, increased complexity of care4 studies29 32 34 35
Supply factors
 Age structure, mortality, retirement, millennial and feminisation trends, full-time and part-time unemployment, manpower work pattern9 studies27–35
 Substitution rates, entry into practice and attrition, foreign medical graduates6 studies27 29–33
 Clinical FTE or % of non-clinical activities (research, teaching, travelling time, time out, time invested in education)6 studies28–30 32 34 35
 Mobility patterns and practice style, migration3 studies27 29 35
 Increasing no of support staff, task shifting, skill mix, expansion in roles3 studies27 29 35
 General labour market regulations (eg, Working Time Directive), economic and political factors, unemployment6 studies27 30–34
 Productivity rates, caseload, referrals4 studies27 28 30 31
 Practice organisation, staffing norms, skill mix2 studies27 35
 Payment methods, incentives2 studies27 35
 Job satisfaction factors2 studies29 31
 Spouse’s employment status1 study31
  • (1) Authors of the included studies have adjusted for known US health market inefficiencies, eg, that FFS (fee-for-service) practices require 56% more physicians compared with HMO (health maintenance organisations).