PubMed · 5208878
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L G Perekopskaia. 1970. ["Demographic explosion" in the developing countries].. https://pubmed.ncbi.nlm.nih.gov/5208878/
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Physician supply and demand for the period extending to 2020 were assessed from three perspectives: physician utilization in group- and staff-model health maintenance organizations, physician distribution, and the future supply of nonphysician clinicians. The national norm for physician demand in 1993 was estimated to be 205 per 100,000 population. Demand is projected to increase 18% by 2020, because of both an expansion in beneficial services and a reduction in physician work effort. Supply initially will increase more rapidly, resulting in a surplus of 31,000 physicians (5% of patient care physicians) in the year 2000 and increasing to 62,000 physicians (8%) in 2010, after which the gap will narrow. Similar results were obtained when previous studies that had projected surpluses of 73,000 to 165,000 physicians (15% to 30%) in the year 2000 were reevaluated. However, physician distribution is not homogeneous, and the number of physicians per capita currently varies by more than twofold among states. Relative to the national norm, surpluses already exist in some states and shortages in others. In addition, the supply of nonphysician clinicians with independent practice authority is increasing. Their numbers are projected to double by 2010, equaling 60% of the number of patient care physicians. Measured as physician equivalents, their growth will equal the growth in physician supply. Thus, in terms of physicians alone, there is no evidence of a major impending national surplus. Local surpluses will be influenced principally by how physicians distribute themselves geographically. The major determinant of overall physician surpluses in the future will be the extent to which patients continue to seek physicians for services that also will be offered by an expanded workforce of nonphysician clinicians. Policy is needed that encompasses the universe of clinicians who will be providing care to patients in the next century.
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In the period 1971-1990 the first admission rate to Danish psychiatric hospitals and wards decreased by approximately 45%. This might reflect the similar decrease in number of available psychiatric beds. Generally, the decrease of first admission rates was larger in the metropolitan area than in the rest of the country. Consequently, the disparity in admission rates between town and country was reduced. This is probably due to the decentralization initiated in the mid-seventies when the counties were made responsible for the psychiatric services in Denmark. Furthermore, changes in morbidity could add to the occurrence of regional variations. Number of available beds has gained increasing importance as a predictor of variations between counties and municipalities whereas the importance of distance to hospital and degree of urbanization has declined. As regards sociodemographic variables special importance should be attached to variables for the amount of social aid and the employment rate in the social and health sector. However, it is generally difficult to determine whether regional variations are due to differences in treatment facilities or morbidity differences.