• 보건행정학회지
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• 제27권1호
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• pp.18-29
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• 2017

Background: In Korea, the problem of physician workforce imbalances has been a debated issue for a long time. This study aimed to draw key lessons and policy implications to Korea by analyzing projection models of physician demand/supply among five countries. Methods: We adopted theoretical framework and analyzed detail indicators used in projection models of demand/supply comparatively among countries. A systematic literature search was conducted using PubMed and Google Scholar with key search terms and it was complimented with hand searching of grey literature in Korean or English. Results: As a results, Korea has been used a supply-based traditional approach without taking various variables or environmental factors influencing on demand/supply into consideration. The projection models of USA and Netherlands which considered the diversity of variables and political issues is the most closest integrated approach. Based on the consensus of stakeholder, the evolved integrated forecasting approach which best suits our nation is needed to minimize a wasteful debate related to physician demand/supply. Also it is necessary to establish the national level statistics indices and database about physician workforce. In addition, physician workforce planning will be discussed periodically. Conclusion: We expect that this study will pave the way to seek reasonable and developmental strategies of physician workforce planning.

• 대한예방한의학회지
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• 제17권1호
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• pp.149-162
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• 2013

Objectives : This study was conducted to estimate the future demand and supply of physicians for korean medicine from 2016 year to 2026 year in order to make an adequate manpower policy in a way of keeping a balance between demand and supply. Methods : Baseline projection method and trend analysis(a polynomial log power equation model) were used in the estimation of future supply and demand respectively. We used data about the amount of oriental doctors from Ministry of Health and Welfare Statistics Yearbook and the treatment days from HIRA Statistics Yearbook. Results : It was projected that the total number of physician of Korean medicine will be 25,178 registered and 18,967 available in clinical setting. According to polynomial equation model which explained the trend of demand and had the highest score of $R^2$ among the equation models, 3,800~5,600 physician in Korean medicine will be oversupplied in 2016 year, 9,000~10,700 physicians in 2021 year and 15,700~17,000 persons in 2026 year depends on annual working days which is 265days, 255days or 239days. Log equation model also showed that overall excess supply of physician manpower in Korean medicine. Conclusions : Alternative manpower policies for Korean medicine doctors should be implemented in a way of both dwindling supplies and growing demand in Korean medical service in terms of Korean medical services utilization and improving physician's productivity.

• 대한예방한의학회지
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• 제8권2호
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• pp.1-12
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• 2004

This paper estimated the demand and supply of physicians for oriental medicine for the period of $2009{\sim}2019$. Two equation models were used in the estimation of manpower. In 2004, the total number of physicians of oriental medicine was amounted to 13,662 registered and 10,532 available in clinical practice, respectively. According to estimates in the study, overall excess supply of physician manpower in oriental medicine was expected in the period, such as $5,300{\sim}5,700$ persons in 2009 and $900{\sim}1,700$ persons in 2019. However, the excess supply would be mitigated after 2019 mainly due to an increase in demand for oriental medical services. Specially, opening medical service market to overseas could be an exogenous variable in physician supply. An alternative manpower policy for oriental medical doctors is needed in a way of controlling oversupply.

• 보건행정학회지
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• 제32권1호
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• pp.73-93
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• 2022

Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion: This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

• 보건행정학회지
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• 제1권1호
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• pp.136-152
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• 1991

The study was conducted to project supply and demand of the physicians from year 1991 to year 2010 based on the analysis of supply and demand of the physicians up to year 1989. Results of the study will provide information for the physicians manpower planning of the 7th 5-year Economic Social Development Planning(1992-1996) and contribute to the overall health manpower planning for the 21the century. It is projected that physician will be oversupplied from the very near future based on the current productivity or underestimated based on the optimal productivity. Thus, it is desirable not to change size of training and education during the 7the 5-year planning period and re-examine the status of the physician manpower at the end of the 7th 5-year period taking into consideration medical services utilization pattern, patients' satisfaction, and physicians' productivity.

• 보건행정학회지
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• 제34권2호
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• pp.120-128
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• 2024

2024년 2월부터 현재까지 의과대학 입학정원 확대를 두고 논란이 계속되고 있다. 이런 논란은 현재와 미래의 시점의 문제가 혼합되어 논란을 더 가중하고 있다. 현시점에서 의사의 인력부족 여부에 대한 논란은 다양하다. 동일한 근거가 의사 부족 또는 부족하지 않은 근거로 제시되기도 한다. 부족하다는 근거로 제시하는 것에 대해서도 이견이 많으며 그 반대의 근거도 이견이 많다. 현시점에서 의사 부족 여부를 둘러싼 이런 논란은 합의될 가능성이 그리 크지 않다. 10년 후에는 노인인구의 급격한 증가로 인해 의사가 더 필요하게 될 것이므로 의과대학 입학인원을 늘려야 할 것이다. 그러나 그 숫자는 의학교육의 질이 저하되지 않을 수준이어야 한다. 이를 위해 의학교육의 질이 높은 의과대학에 더 많은 입학인원을 배정해야 하며, 그 대안으로 대규모 의과대학은 입학인원을 20%-30% 늘리고, 소규모 의과대학은 입학인원을 40%-50% 늘리면 전체 증가인원은 760-1,066명이 되는 것이다. 2,000명 증원이 강행된다면 의학교육의 질을 면밀히 평가해 그 결과를 의과대학 정원 조정에 반영해야 할 것이다. 20년 후에는 의과대학 입학정원을 줄여야 한다. 이는 의사공급이 1차함수로 증가할 것인데 반해 의사수요(의료수요)가 꼭지점이 있는 2차함수로 변화하고 있기 때문이다. 현재의 인원을 유지하더라도 2048년부터는 의사가 과잉되기 때문에 의과대학 입학인원을 줄여야 하며, 규모는 현재보다 1,000명이 적은 2,000명 정도로 축소해야 할 것이다. 정원 축소 시 모든 의과대학에 일률적으로 축소한다면 소규모 의과대학이 많아지기에 M&A (mergers and acquisitions) 전략을 적용해야 할 것이며, 그 대상은 40개의 의과대학과 12개의 한의과대학이어야 할 것이다. 우리나라의 경우 의사수요 추정에 가장 큰 영향을 미치는 요인은 인구 변화이다. 합계출산율의 급격한 감소로 인해 향후 인구 전망은 불확실성이 상당 수준 있으며, 최근 의료이용률의 급격한 증가가 반영된 수급추계는 재검토되어야 한다. 의사 수급추계의 불확실성으로 인해 의사 수급추계는 최소한 5년 단위로 지속적으로 실시되어야 하며, 이를 위해 보건의료인력검토위원회를 설치 운영해야 한다.

• Journal of Preventive Medicine and Public Health
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• 제52권2호
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• pp.72-81
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• 2019

Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

• 농촌의학ㆍ지역보건
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• 제49권3호
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• pp.235-256
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• 2024

Background: The adequate provision of medical care relies on the availability of a suitable number of healthcare professionals. To ensure stability in healthcare delivery, it is crucial for a country to accurately estimate and address the supply of doctors. This study aims to contribute to the formulation of effective policies for securing and distributing doctor manpower, with a focus on medically underserved areas at both the national and local government levels. Methods: Employing the system dynamics methodology, this research utilizes stock and flow diagrams, including level and rate diagrams, to quantitatively analyze the cumulative structure of the doctor supply and demand system. Results: The analysis reveals a substantial shortage of clinical doctors in Gyeongsangnam-do, amounting to 15,477 as of 2021. Projections indicate a need for an additional 7,570 doctors by the year 2050 to maintain the current healthcare service level. Examination of medical treatment rights and distribution across cities and counties indicates an insufficiency in doctor supply relative to demand in the majority of regions. Alternative scenarios, such as increasing medical school enrollments and adjusting retirement ages, were explored, yet none provided a sufficient resolution to the shortage. Conclusion: The findings underscore an impending exacerbation of the doctor shortage in Gyeongsangnam-do if the existing system is perpetuated. Addressing this issue necessitates not only augmenting the number of medical school students and adapting retirement age policies but also implementing diverse strategies employed successfully in other countries. This study serves as a foundational step in informing evidence-based policies aimed at securing an ample and appropriately distributed doctor workforce for sustainable healthcare delivery.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.61-69
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• 1988

In this study, the number of physicians presently living in Korea was thoroughly estimated by several means and, on this basis, their productivity and level of supply were estimated. The results were as follows First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%) ,861 military medical officers,745 public health doctors, and 107 deceased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were deceased. Practicing physicians difined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038, and 57,655, respectively and these are increases of 115.0%, 113.9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physician supply. From the results of the present analysis of physician manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy of physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
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• pp.307-308
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• 1996