System Dynamics Modeling of Health Workforce Planning to Address Future Challenges of Thailand’s Universal Health Coverage

Abstract

Background: System dynamics modeling can inform policy decisions of healthcare reforms under Thailand’s Universal Health Coverage. We report on this thinking approach to Thailand’s strategic health workforce planning for the next 20 years.Methods: A series of group model building sessions involving 110 participants from multi-sectors of Thailand’s health systems was conducted in 2017 and 2018. Policymakers, healthcare administrators, and practitioners were facilitated to co-create a causal loop diagram representing a shared understanding of why the demands and supplies of the health workforce in Thailand can be mismatched and a stock and flow diagrams for testing the consequences of policy options.Results: Our simulation modeling found hospital utilizations created a vicious cycle of constantly increasing demands for hospital care, and hence a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of aging populations and prevalent chronic illness. Hence, shifting emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care, and end-of-life care can be more effective.Conclusions: The system dynamics modeling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term.

Correction to: System dynamics modelling of health workforce planning to address future challenges of Thailand’s Universal Health Coverage

“…Following the publication of the original article [ 1 ], an error was identified in the Conclusions of the Abstract section.…”

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

“…Thus, the bottom line is not just implementing or not implementing the lockdown, but it is, if the lockdown is to be implemented, how the Thai Government maintains the national economy (or at least minimizes the economic damage). A recent study from Israel suggests that a cyclical lockdown strategy (four days of complete lockdown alternating with ten days of reopening) was effective at halting the epidemic while limiting the negative effects on the economy [ 19 ]. However, such a proposal might not be practical in reality, as it significantly disrupted the working life of most people.…”

“…The official announcement to the public suggested that the lockdown policy was likely to be in effect for about 30–60 days. During the first wave of COVID-19 in Thailand, in early 2020, Leerapan et al estimated that the lockdown helped reduce the reproduction number by about 20% [ 19 ]. We postulated that the effect of the lockdown measure might vary between 20 and 60% as, this time, there were many more additional measures compared with the first wave, such as mass COVID-19 vaccination campaigns and active community screening.…”