Working life of health professionals.

A comparison was made between the indirect method of preparing a profession-specific working-life table and the direct method. The former uses data on the number of physicians per 1,000 population by age and assumes that the mortality rate for the profession is equal to that of the population as a whole. The latter method makes use of information on profession-specific mortality and on active and inactive status of living physicians. These two approaches were applied to physician data for the United States of America and it was noted that the direct method gives estimates of working life and total life expectancy that are significantly higher than by use of the indirect method. The likely magnitude and directions of the biases inherent in each of the methods are then discussed. A comparison is then made of the estimated working life for Colombian, French and US physicians using the indirect method.

The unmet demand for health services: a vital component in planning.

Consideration of unmet need as well as effective demand for health services is desirable for planning but frequently ignored. This paper reports an analysis of the findings from a national health survey conducted in Chile to obtain information on both met and unmet demand. The joint analysis proved feasible and highly informative. Total felt need tended to be relatively constant among population groups in comparison with differences in actual services utilization. Moreover, exceptions to this general finding revealed patterns that should improve our insights for health planning.

Measurement and projection of the demand for health care: the Chilean experience.

Projection of the probable demand for health services over time is one of the most important-and difficult-aspects of the health planning process. Not only must the planner contend with many variables external to the health sector, but also with the difficult to predict correlations between the supply of health, services and the resultant demand. This article briefly reviews some of the principal demand projection methods in use and then describes in detail the one adopted in the Chilean health manpower study. The demand portion of the study in Chile involved three main elements: 1) a sample survey which measured the met and unmet demand for medical, dental, and hospital services as a function of six population variables (age, sex, location, income, educational level, and medical insurance status); 2) a baseline demand projection which takes into account the probable effects of changes in these six variables over ten and 20 years on the utilization of services; and 3) an alternative projection which postulates the fulfillment of certain targets for the improvement of health care. The approach offers the planner a number of important analytical and programmatic advantages compared with other methods now available and are discussed along with their limitations.