CEOM Plenary Meeting Medical Demography Presentation of the SNAPS Working Group Luxembourg 12.6.2015 Hannu Halila Deputy CEO, Finnish Medical Association MD PhD, Specialist in Obstetrics and Gynaecology, Adjunct Professor in Health Care Administration, emba
Hannu Halila Disclosure Employed by the Finnish Medical Association Adjunct professor of health care administration, University of Helsinki Practicing part time gynaecologist Past-President, UEMS, European Union of Medical Specialists Member of the Rome CME/CPD Group sponsored by the Society for Worldwide Medical Exchange
Nordic Countries Already from 1954 a joint Nordic labour market for health care personnel This has been continued even after Denmark, Sweden and Finland are members of the EU This agreement allows free movement of doctors more widely than the European Union Directive on professional recognition
Nordic Medical Associations A lot of collaboration in various fields Similar cultural background Homogeneous population Swedish, Danish and Norwegian languages close to each other Health care systems quite similar
SNAPS A working group of the Nordic medical associations dealing with workforce prognosis and specialist training issues Founded in 1976, first report in 1978 Reports in Swedish language, a small leaflet, Physicians in the Nordic countries, in English also
S AM N ORDISK A RBETSGRUPP FÖR P ROGNOS- OCH S PECIALISTUTBILDNINGSFRÅGOR
SNAPS
Meetings yearly, reports every two years Meeting place rotates between the five countries as well as leadership of the group The group discussed the future the prognoses work in its meeting in May 2015, full extensive printed reports perhaps not possible to publish anymore in the future, ather collection of the national prognosis reports in English in Internet
SNAPS Prognosis for Medical Manpower Various different factors used in the prognosis of workforce supply: Current workforce Average age in the beginning of medical studies Medical education Dropout rate during studies Retirement Mortality during working life Part-time work Yearly working time Proportion of doctors outside the workforce or in other sectors Migration of doctors (immigration and emigration)
Demand of Doctors Traditionally the five countries have used different scenarios for doctors demand One model is based on constant physicians/population-ratio The other model is based on estimation of economic growth and the growing need of doctors
Example :SNAPS 2008 Prognosis Demand of Doctors Finland Iceland Norwa y Sweden Alternative A (economic growth) Alternative B (increase of population) 0.5 % 0 % 2.7 % 1.6 % 0.3 % 1.06 % 2.1 %* 0.4 %
Example :SNAPS 2008 Prognosis Supply and demand (surplus + shortage ) Finland Iceland Norway Sweden A B A B A B A B 2007 900 900 0 0 400 400 1850 1850 2010 500 400 +110 +74 0 +300 2350 1400 2015 0 +200 +281 +182 400 +400 4400 1650 2020 100 +300 +367 +202 1100 +200-6000 - 100 2025 100 +500 +427 +193 2000 200 Alternative A Alternative B economic growth population growth
Finland - The assumptions of the model The length of basic medical training is 6 years, drop-out rate is 5%. Proportion of female students is expected to stay at 60%. The percentage of physicians working in their profession is 93% for male physicians and 87% for female physicians. About 14% of men and 23% of women are working part-time, 60% of full-time work. An average physician is expected to have a working life of 38 years. The retirement age is 65 years. About 50% of physicians continues working after reaching age of 65. Net migration of physicians is + 60 per year.
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30 Tilastotietoja lääkäreistä ja terveydenhuollosta 2014 Statistics on physicians and the health care system 2014
The demand of doctors is much more difficult to estimate than the supply Historically the supply of doctors has been quite accurately predicted but the demand has changed very much even at short intervals The most difficult factor to predict is the economic growth and the possibilities of national governments to invest in health care
Migration of Doctors Within the Nordic Countries Traditionally this has been quite active because of similar languages and health care systems SNAPS prognosis has helped in predictions: one country may predict shortage of doctors and another surplus of doctors which is balanced by migration
SNAPS prognosis work has also been as a model for national predictions of the Nordic countries and has helped in the discussion about the future need of doctors and the number of new medical students SNAPS model is quite well-known even among national governments in the Nordic countries SNAPS working group is a useful network for exchange of information of the developments in the different Nordic countries
Kiitos! Tack!Thanks! Merci! 34