Healthcare Human Resource Planning

  • John Pastor Ansah
  • Victoria KohEmail author
  • Steffen Bayer
  • Paul Harper
  • David Matchar
Part of the International Series in Operations Research & Management Science book series (ISOR, volume 262)


Healthcare human resource planning is an important aspect of health policy. Its importance arises in particular from the long time-delays, high-costs for training, and high proportion of healthcare expenditure allocated to it. Many countries experience workforce shortages in the healthcare sector, especially among nursing staff. This also has huge implications for population health; morbidity and mortality can increase in the face of inadequate healthcare human resources. Yet, the high degree of uncertainty related to policies, costs and patient behavior makes long-term planning a significant challenge. In this light, this chapter will discuss different analytical techniques used in healthcare human resource planning. Two case studies are presented to provide examples of real-world applications across different institutional context. One employs a systems methodology, while the other uses a linear programming method. Specifically, they aim to demonstrate the importance of adequate planning, and the various elements that need to be accounted for when planning healthcare human resources.


Healthcare human resource planning Health policy Analytic techniques Simulation modeling 


  1. Agerholm J, Bruce D, Ponce De Leon A, Burstrom B (2013) Socioeconomic differences in healthcare utilization, with and without adjustment for need: an example from Stockholm, Sweden. Scand J Public Health 41:318–325CrossRefGoogle Scholar
  2. Aluttis C, Bishaw T, Frank MW (2014) The workforce for health in a globalized context – global shortages and international migration. Glob Health Action 7:23611CrossRefGoogle Scholar
  3. Andersen R, Newman JF (1973) Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Q Health Soc 51:95–124CrossRefGoogle Scholar
  4. Ansah J, De Korne D, Bayer S, Pan C, Jayabaskar T, Matchar D, Lew N, Phua A, Koh V, Lamoureux E, Quek D (2015) Future requirements for and supply of ophthalmologists for an aging population in Singapore. Hum Resour Health 13:86CrossRefGoogle Scholar
  5. Anson BR (2000) Taking charge of change in a volatile healthcare marketplace. Hum Resour Plan 23:21Google Scholar
  6. Anyangwe SCE, Mtonga C (2007) Inequities in the global health workforce: the greatest impediment to health in sub-Saharan Africa. Int J Environ Res Public Health 4:93–100CrossRefGoogle Scholar
  7. Asher MG, Nandy A (2008) Singapore’s policy responses to ageing, inequality and poverty: an assessment. Int Soc Secur Rev 61:41–60CrossRefGoogle Scholar
  8. Barber P, López-Valcárcel BG (2010) Forecasting the need for medical specialists in Spain: application of a system dynamics model. Hum Resour Health 8:24–24CrossRefGoogle Scholar
  9. Birch S, Kephart G, Tomblin-Murphy G, O'brien-Pallas L, Alder R, Mackenzie A (2007) Human resources planning and the production of health: a needs-based analytical framework. Can Public Policy 33:1–16CrossRefGoogle Scholar
  10. Bloor K, Maynard A Hall J (2003) Planning human resources in health care: towards an economic approach: an international comparative review. Canadian Health Services Research Foundation= Fondation canadienne de la recherche sur les Services de santé, CANADAGoogle Scholar
  11. Buchan J, Calman L (2005) Skill-mix and policy change in the health workforce: nurses in advanced role. OECD health working papers no. 17, OECD, FRANCEGoogle Scholar
  12. Buchan J, Sochalski J (2004) The migration of nurses: trends and policies. Bull World Health Organ 82:587–594Google Scholar
  13. Centre for Workforce Intelligence (2014a) Horizon 2035: health and care workforce futures Progress updateGoogle Scholar
  14. Centre for Workforce Intelligence (2014b) Robust workforce planning framework: an introduction. CfWI technical paper series no. 0001Google Scholar
  15. Chung SH, Jung DC, Yoon SN, Lee D (2010) A dynamic forecasting model for nursing manpower requirements in the medical service industry. Serv Bus 4:225–236CrossRefGoogle Scholar
  16. Cooper RA, Cooper MA, Mcginley EL, Fan X, Rosenthal JT (2012) Poverty, wealth, and health care utilization: a geographic assessment. J Urban Health 89:828–847CrossRefGoogle Scholar
  17. Cromwell J, Rosenbach ML, Pope GC, Butrica B, Pitcher JD (1991) CRNA manpower forecasts: 1990-2010. Med Care 29:628–644CrossRefGoogle Scholar
  18. Dall TM, Storm MV, Chakrabarti R, Drogan O, Keran CM, Donofrio PD, Henderson VW, Kaminski HJ, Stevens JC, Vidic TR (2013) Supply and demand analysis of the current and future US neurology workforce. Neurology 81:470–478CrossRefGoogle Scholar
  19. Dreesch N, Dolea C, Dal Poz MR, Goubarev A, Adams O, Aregawi M, Bergstrom K, Fogstad H, Sheratt D, Linkins J, Scherpbier R, Youssef-Fox M (2005) An approach to estimating human resource requirements to achieve the Millennium Development Goals. Health Policy Plan 20:267–276CrossRefGoogle Scholar
  20. Dubois CA, Singh D (2009) From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management. Hum Resour Health 7:87CrossRefGoogle Scholar
  21. Dussault G, Buchan J, Sermeus W, Padaiga Z (2010) Assessing future health workforce needs. World Health Organization, CopenhagenGoogle Scholar
  22. Dussault G, Franceschini MC (2006) Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health 4:12CrossRefGoogle Scholar
  23. Edwards JP, Datta I, Hunt JD, Stefan K, Ball CG, Dixon E, Grondin SC (2014) A novel approach for the accurate prediction of thoracic surgery workforce requirements in Canada. J Thorac Cardiovasc Surg 148:7–12CrossRefGoogle Scholar
  24. Evashwick C, Rowe G, Diehr P, Branch L (1984) Factors explaining the use of health care services by the elderly. Health Serv Res 19:357–382Google Scholar
  25. Feldstein MS (1967) An aggregate planning model of the health care sector. Med Care 5:369–381CrossRefGoogle Scholar
  26. Feldstein PJ, Roehrig CS (1980) A national econometric forecasting model of the dental sector. Health Serv Res 15:415–432Google Scholar
  27. Forrester JW (1961) Industrial dynamics. M.I.T. Press, Cambridge, MAGoogle Scholar
  28. Frank E, Rothenberg R, Brown WV, Maibach H (1997) Basic demographic and professional characteristics of US women physicians. West J Med 166:179–184Google Scholar
  29. Fu MC, Buerba RA, Gruskay J, Grauer JN (2013) Longitudinal urban-rural discrepancies in the US orthopaedic surgeon workforce. Clin Orthop Relat Res 471:3074–3081CrossRefGoogle Scholar
  30. Fulton BD, Scheffler RM, Sparkes SP, Auh EY, Vujicic M, Soucat A (2011) Health workforce skill mix and task shifting in low income countries: a review of recent evidence. Hum Resour Health 9:1–1CrossRefGoogle Scholar
  31. Girifalco LA (1991) Dynamics of technological change. Springer US, BostonCrossRefGoogle Scholar
  32. Goodman DC (1996) Benchmarking the US physician workforce. An alternative to needs-based or demand-based planning. JAMA 276:1811–1817CrossRefGoogle Scholar
  33. Goodman HS, Weyant RJ (1990) Dental health personnel planning: a review of the literature. J Public Health Dent 50:48–63CrossRefGoogle Scholar
  34. Government of Singapore (2014) Pioneer generation package – overview [Online]. Available: Accessed 5 Nov 2014
  35. Gray SF, Spry PG, Brookes ST, Peters TJ, Spencer IC, Baker IA, Sparrow JM, Easty DL (2000) The Bristol shared care glaucoma study: outcome at follow up at 2 years. Br J Ophthalmol 84:456–463CrossRefGoogle Scholar
  36. Green LV, Savin S, Lu Y (2013) Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication. Health Aff (Millwood) 32:11–19CrossRefGoogle Scholar
  37. Hall TL, Mejia A (1978) Health manpower planning: principles, methods, issues. World Health Organization, AlbanyGoogle Scholar
  38. Harper P, Kleinman E, Gallagher J, Knight V (2013) Cost-effective workforce planning: optimising the dental team skill-mix for England. J Enterp Inf Manag 26:91–108CrossRefGoogle Scholar
  39. Hawthorne L, Hamilton J (2010) International medical students and migration: the missing dimension in Australian workforce planning? Med J Aust 193:262Google Scholar
  40. Homer JB (1996) Why we iterate: scientific modeling in theory and practice. Syst Dyn Rev 12:1–9CrossRefGoogle Scholar
  41. Homer JB, Hirsch GB (2006) System dynamics modeling for public health: background and opportunities. Am J Public Health 96:452–458CrossRefGoogle Scholar
  42. Hooker RS, Cawley JF, Everett CM (2011) Predictive modeling the physician assistant supply: 2010–2025. Public Health Rep (1974) 126:708–716CrossRefGoogle Scholar
  43. Huang CS, Cher T-L, Lin C-P, Wu K-M (2013) Projection of the dental workforce from 2011 to 2020, based on the actual workload of 6762 dentists in 2010 in Taiwan. J Formos Med Assoc = Taiwan yi zhi 112:527CrossRefGoogle Scholar
  44. Hulka BS, Wheat JR (1985) Patterns of utilization: the patient perspective. Med Care 23:438–460CrossRefGoogle Scholar
  45. Hurst K, Kelley Patterson D (2014) Health and social care workforce planning and development – an overview. Int J Health Care Qual Assur 27:562–572CrossRefGoogle Scholar
  46. Ishikawa T, Ohba H, Yokooka Y, Nakamura K, Ogasawara K (2013) Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach. Hum Resour Health 11:41–41CrossRefGoogle Scholar
  47. Kimball A, Resneck JS, Jacobson CC (2004) Generational differences in practice patterns of dermatologists in the United States. Arch Dermatol 140:1477Google Scholar
  48. Kirch DG, Henderson MK, Dill MJ (2012) Physician workforce projections in an Era of health care reform. Annu Rev Med 63:435–445CrossRefGoogle Scholar
  49. Kurowski C, Wyss K, Abdulla S, Mills A (2007) Scaling up priority health interventions in Tanzania: the human resources challenge. Health Policy Plan 22:113–127CrossRefGoogle Scholar
  50. Lavieri MS, Puterman ML (2009) Optimizing nursing human resource planning in British Columbia. Health Care Manag Sci 12:119–128CrossRefGoogle Scholar
  51. Loh PT, Toh MP, Molina JA, Vathsala A (2015) Ethnic disparity in prevalence of diabetic kidney disease in an Asian primary healthcare cluster. Nephrology (Carlton) 20:216–223CrossRefGoogle Scholar
  52. Lomas J, Stoddart GL, Barer ML (1985) Supply projections as planning: a critical review of forecasting net physician requirements in Canada. Soc Sci Med 20:411–424CrossRefGoogle Scholar
  53. Machry RV, Tuchtenhagen S, Agostini BA, Da Silva Teixeira CR, Piovesan C, Mendes FM, Ardenghi TM (2013) Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children. BMC Oral Health 13:60–60CrossRefGoogle Scholar
  54. Masnick K, Mcdonnell G (2010) A model linking clinical workforce skill mix planning to health and health care dynamics. Hum Resour Health 8:11–11CrossRefGoogle Scholar
  55. Maynard A (2006) Medical workforce planning: some forecasting challenges. Aust Econ Rev 39:323–329CrossRefGoogle Scholar
  56. Miller S (2012) The effect of the Massachusetts reform on health care utilization. Inquiry 49:317–326Google Scholar
  57. North N, Hughes F (2012) A systems perspective on nursing productivity. J Health Organ Manag 26:192–214CrossRefGoogle Scholar
  58. O’connor PM, Alex Harper C, Brunton CL, Clews SJ, Haymes SA, Keeffe JE (2012) Shared care for chronic eye diseases: perspectives of ophthalmologists, optometrists and patients. Med J Aust 196:646CrossRefGoogle Scholar
  59. O’brien-Pallas L, Baumann A, Donner G, Murphy GT, Lochhaas-Gerlach J, Luba M (2001) Forecasting models for human resources in health care. J Adv Nurs 33:120–129CrossRefGoogle Scholar
  60. OECD (2013) Health at a glance 2013: OECD indicators. OECD Publishing, CANADAGoogle Scholar
  61. Park E, Kim J (2015) Gender- and age-specific prevalence of metabolic syndrome among Korean adults: analysis of the fifth Korean National Health and Nutrition Examination Survey. J Cardiovasc Nurs 30:256–266CrossRefGoogle Scholar
  62. Park JM (2014) Health status and health services utilization in elderly Koreans. Int J Equity Health 13:73–73CrossRefGoogle Scholar
  63. Rhoads J, Ferguson LA, Langford CA (2006) Measuring nurse practitioner productivity. Dermatol Nurs 18(1):32–38Google Scholar
  64. Roberfroid D, Leonard C, Stordeur S (2009) Physician supply forecast: better than peering in a crystal ball? Hum Resour Health 7:10–10CrossRefGoogle Scholar
  65. Scheffler RM, Liu JX, Kinfu Y, Dal Poz MR (2008) Forecasting the global shortage of physicians: an economic- and needs-based approach. Bull World Health Organ 86:516–523CrossRefGoogle Scholar
  66. Scott A (2011) Alternative approaches to health workforce planning. School of Population Health, University of Queensland, CANADAGoogle Scholar
  67. Senese F, Tubertini P, Mazzocchetti A, Lodi A, Ruozi C, Grilli R (2015) Forecasting future needs and optimal allocation of medical residency positions: the Emilia-Romagna Region case study. Hum Resour Health 13:7CrossRefGoogle Scholar
  68. SINGHEALTH (2008) Singapore National Eye Centre opens new clinic in Balestier [Online]. Available: Accessed 5 Nov 2014
  69. Spetz J, Trupin L, Bates T, Coffman JM (2015) Future demand for long-term care workers will be influenced by demographic and utilization changes. Health Aff (Project Hope) 34:936CrossRefGoogle Scholar
  70. Standard Chartered Bank (2014) Standard chartered launches Mobile Eye Clinic – Singapore’s first comprehensive eye care on-the-move for senior citizens [Online]. Available: Accessed 5 Nov 2014
  71. Starfield B, Shi L, Grover A, Macinko J (2005) The effects of specialist supply on populations’ health: assessing the evidence. Health Aff 24:W5Google Scholar
  72. Sterman J (2000) Business dynamics: systems thinking and modeling for a complex world. Irwin/McGraw-Hill, BostonGoogle Scholar
  73. Teo Z (2013) Educational profile of Singapore resident non-students, 2002–2012. In Department of Statistics Singapore, ed, OECD, FRANCEGoogle Scholar
  74. Teye JK, Setrana MB, Acheampong AA (2015) Migration of health professionals from Ghana: trends, drivers, and emerging issues. Curr Polit Econ Afr 8:459Google Scholar
  75. Thompson MJ, Christian Lynge D, Larson EH, Rosenblatt RA, Hart LG (2008) A longitudinal analysis of the general surgery workforce in the United States, 1981-2005. Arch Surg 143:345–350CrossRefGoogle Scholar
  76. Tjoa A, Kapihya M, Libetwa M, Schroder K, Scott C, Lee J, Mccarthy E (2010) Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia. Hum Resour Health 8:15–15CrossRefGoogle Scholar
  77. Tomblin Murphy G, Mackenzie A, Guy-Walker J, Walker C (2014) Needs-based human resources for health planning in Jamaica: using simulation modelling to inform policy options for pharmacists in the public sector. Hum Resour Health 12:67–67CrossRefGoogle Scholar
  78. United States Bureau of Health Resources Development (1974) Registered nurses. In The supply of health manpower: 1970 profiles and projections to 1990Google Scholar
  79. Van Der Heyden JHA, Demarest S, Tafforeau J, Van Oyen H (2003) Socio-economic differences in the utilisation of health services in Belgium. Health Policy 65:153–165CrossRefGoogle Scholar
  80. Wang J (2005) A review of operations research applications in workforce planning and potential modeling of military training. DTIC DocumentGoogle Scholar
  81. Weiner JP (1994) Forecasting the effects of health reform on US physician workforce requirement: evidence from HMO staffing patterns. JAMA 272:222–230CrossRefGoogle Scholar
  82. Wendt C (2009) Mapping European healthcare systems: a comparative analysis of financing, service provision and access to healthcare. J Eur Soc Policy 19:432–445CrossRefGoogle Scholar
  83. Willis G, Woodward A , Cave S (2013) Robust workforce planning for the English medical workforce. In The 31st International Conference of the System Dynamics SocietyGoogle Scholar
  84. Wong TY, Loon S-C, Saw S-M (2006) The epidemiology of age related eye diseases in Asia. Br J Ophthalmol 90:506–511CrossRefGoogle Scholar
  85. World Health Organization (2007) Task shifting to tackle health worker shortages. World Health Organization, GenevaGoogle Scholar
  86. Wu M-H, Yu J-Y, Huang C-H (2013) Theoretical system dynamics modeling for Taiwan pediatric workforce in an era of national health insurance and low birth rates. Pediatr Neonatol 54:389–396CrossRefGoogle Scholar
  87. Yett DE, Drabek L, Intriligator MD, Kimbell LJ (1972) Health manpower planning: an econometric approach. Health Serv Res 7:134–147Google Scholar
  88. Yett DE, Drabek L, Intriligator MD, KIMBELL LJ (1975) A microeconometric model of the health care system in the United States. Ann Econ Soc Meas 4:3Google Scholar
  89. Zhang M, Katzman R, Salmon D, Jin H, Cai G, Wang Z, Qu G, Grant I, Yu E, Levy P, Klauber MR, Liu WT (1990) The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education. Ann Neurol 27:428–437CrossRefGoogle Scholar
  90. Zheng Y, Cheng CY, Lamoureux EL, Chiang PP, Rahman Anuar A, Wang JJ, Mitchell P, Saw SM, Wong TY (2013) How much eye care services do Asian populations need? Projection from the Singapore epidemiology of eye disease (SEED) study. Invest Ophthalmol Vis Sci 54:2171–2177CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • John Pastor Ansah
    • 1
  • Victoria Koh
    • 1
    Email author
  • Steffen Bayer
    • 2
  • Paul Harper
    • 3
  • David Matchar
    • 1
  1. 1.Health Services and Systems Research, Duke-NUS Medical SchoolSingaporeSingapore
  2. 2.Southampton Business SchoolUniversity of Southampton, Highfield CampusSouthamptonUK
  3. 3.School of MathematicsCardiff UniversityCardiffUK

Personalised recommendations