Improving the system of manpower planning in Dutch health care
Worldwide and since a long period of time, shortages of health care personnel is major concern of health policy makers, professional bodies and patient organizations. At a constant rate, policy and market initiatives are taken to attack these problems, most obviously by manpower planning, but also indirectly through changing governance structures, financial regulation, logistics and intermediary actors such as health care insurers. It is commonly acknowledged that manpower planning is an important instrument to control shortages (and oversupply) within the health care labour market imbalances, in particular by increasing or decreasing the numbers to be trained. While there seems a lot variation in the level and system of health manpower planning between countries, little is known so far about its potential or relative success. The Netherlands is one of the countries that has a relative long tradition of manpower planning in health care, and is therefore an interesting case to study.
1. How can we describe the system of health manpower planning for general practitioners in the Netherlands, what are the main systemic and policy principles, how did this system develop historically, and what is the power of the current estimation techniques?
2. What is the robustness of the model for GP manpower planning with regard to developments within the labour market for GPs, such as the dynamics of GPs’ careers, changing retirement age of GPs, substitution between GP and nurse practitioners, as well as local/regional variation?
3. Evaluating the last 10 years, how the Dutch model/system for health manpower planning for GPs be improved, with regard to both its systemic and policy principles?
For this PhD project a series of papers will be written, which will be overarched by an introducing and closing chapter. For the 3 different research questions, different theories and methods will be applied. To describe the Dutch model for manpower planning, a ‘thick’ methodological description will be made, as well as an historical analysis of the Dutch labour market for GPs. In addition, two empirical studies will be performed using NIVEL GP registration databases that contain detailed data on GP career since 1980. The predictability of the manpower planning model will be analyzed using these data, as well as a longitudinal analysis. Finally, a policy evaluation model will be developed, as well an innovation study for health manpower in the Netherlands.
The following scientific papers (preliminary titles) are planned:
1. A model for planning the health workforce in the Netherlands: the GP as an example.
2. A historical analysis of the planning process of inflow in GP training in the Netherlands: between policy and practice.
3. Predictive power of the manpower planning model in the Netherlands.
4. Motives for early retirement of self-employed GPs: a comparative study of two periods.
5. Longitudinal analysis of GP careers.
6. Modeling substitution for manpower planning.
7. Regional differences/variations in manpower planning
8. Comparative analysis of (Dutch) simulation models
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