Background/Purpose: To compare models forecasting adult and paediatric rheumatology work force requirement in Western countries

Methods: A systematic literature review (SLR) was conducted by 2 authors (CD, AL) through medical databases (Ovid MEDLINE®, Embase, CINAHL, Cochrane Library), and the homepages (and referenced links) of the departments of health, rheumatology societies and medical associations of the following countries: Austria, Germany, Switzerland, United Kingdom (UK), Ireland, Canada, USA, Australia, New Zealand. Besides, we searched the homepages of EULAR, the European Commission and related organisations. Additional articles were retrieved by reviewing the reference list of full articles, conference abstracts and by contacting the national rheumatology societies of EULAR countries, USA, Australia, New Zealand, Canada and the EU – Joint action on workforce planning and forecasting. We included only English and German articles providing an estimation of (current and/or future) adult and/or paediatric rheumatology manpower (required to serve the respective population), and describing the methods and factors underlying this calculation. Quality appraisal of included articles was not possible because no appropriate instrument is available. Any discordance between the authors (3% of the papers) was resolved by discussion. The protocol of this SLR was registered at the PROSPERO website (CRD42014013948).

Results: The initial search yielded n=5699 articles, a total of 12 articles (9 papers for adult rheumatology, 1 for paediatric and 2 for adult and paediatric rheumatology) met all inclusion criteria. Rheumatology manpower calculations were available for the USA (3 models), Canada (n=3), USA + Canada (n=1), Germany (n=2), Spain (n=1) and the UK (n=2). There was a large variance regarding the estimated number of rheumatologists ranging from 0.7 (UK, 1988) to 3.5 (Spanish projection for 2021) to serve a population of 100,000 people. For paediatric rheumatology, 1 rheumatologist per 100,000 children (Germany) or 0.7-1.0 per 1,000,000 (of the general) population (USA) were suggested. Most models used a demand (n=3) or needs (n=6) based approach whereas in 3 papers, the underlying method was unclear. The following variables were considered by ≥ 1 model: disease prevalence, proportion of patients that  should be referred to a rheumatologist, clinical visits/patient/year, population development, workforce provided by one rheumatologist full time equivalent, factors influencing workforce capacity, patient flow/care sharing, effect of medical development.

Conclusion: Different methods have been applied to forecast rheumatology work force requirement in Western countries yielding highly variable results with 0.7 to 3.5 rheumatologists required to serve a population of 100,000 people.

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatology-work-force-planning-in-western-countries-a-systematic-literature-review/