Cahiers de sociologie et de demographie medicales最新文献

Utilization of health care is a major concern in the debates about public expenditures and the regulation of human health resources. Concerns regarding inappropriate services are regularly mentioned in Belgium. Our study aims at assessing the utilization of health care, with a particular focus on the impact of morbidity, and a possible sub-consumption behaviour. The probability of having had a medical encounter with a general practitioner or with a specialist during the latest year and the probability of a frequency of encounters higher than national average is assessed thanks to logistic regressions. The functional limitations and the chronic conditions (mainly the poly-pathology) are major factors related to patient encounters with medical doctors. In the future, the number of individuals suffering from functional limitations and/or chronic illness will increase due to the ageing of the population. The pressure on health expenditures will increase also if: the frequency of encounters is adequate, as recommended by the "guidelines" for some illnesses and, the frequency of encounters increases due to the evolution of other factors that have been put forward by our logistic regressions. However, any sub-consumptions cannot be simply labeled as additional real needs, because these are also linked to some characteristics of the patients. Consequently, problems of subconsumption cannot be easily solved just by increasing medical supply.

A survey based on postal questionnaire was carried out in France in Spring 2006 among a sample of 4100 independent professionals from 8 occupations: architects, lawyers, notaries, physicians, dentists, biologists, accountants and sellers of insurance contracts. The objective of the survey is to assess the pool of new jobs which may be created by the independent professionals whose the number in France is approximatively 550000 (total population of France in early 2006 : 62.9 millions). Legally and financially, an independent professional can conduct his business in his own office or within a society gathering several professionals. In the first case (called "solo practice") he may be helped by salaried employees and, recently by other professionals who act as associates. In the second case (called "society practice") he is one of the partners of the society which has generally one or several salaried employees. After the answers gathered by the survey, the number of jobs that the professionals envisage to create during one year is rather important. In the low variant, it is estimated 165200 posts, in the high variant, it may reach 226000 posts. These numbers include salaried employees and professional associates. They cover newly created posts and vacant posts filled in by newcomers. In other words, every 100 French independent professionals plan to create during the coming year between 30 and 41 jobs.

Physician workforce forecasting in the U.S. has returned to preeminence in the recent past. With the publication of the federal Council on Graduate Medical Education's Sixteenth Report: Physician Workforce Policy Guidelines for the United States, 2000-2020, efforts have begun to examine specialty- and geography-specific forecasts to determine the extent to which the projected national shortage of physicians will affect particular specialties and populations in particular areas. This article begins with a brief history of physician workforce forecasting in the U.S. over the past 25 years and summarizes the findings of two state-specific attempts to forecast physician supply and demand in the coming years. Discussions of the findings from the two studies as well as a brief commentary on how particular model assumptions obfuscate interpretation of the forecasts are provided. Finally, a brief discussion of how the forecasts were used by stakeholders in each state is presented.