Human Resource Planning:
Lithuanian Physicians in the
Process of Accession
Zilvinas Padaiga
Vice-Rector
Kaunas University of Medicine
Lithuania
6th European Health Forum Gastein
1st - 4th October 2003
"Health and wealth - social and economic dimensions of health"
Based on:
1. Survey of WHO Liaison Officers of 8 accession countries
(BUL, HUN, LVA, LTU, POL, ROM, SLO, SLK) – training,
licensing, employment and planning of HHR;
2. Survey of physicians and residents in LTU re potential
migration to EU and other countries after accession;
3. Prognosis of number of physicians until the year 2015 in
LTU;
4. Survey of experts re recommended number of physicians
in LTU during the next decade – Delphi study;
5. WHO HFA DB, National License Registry, Sickness Fund
DB, National Health Information Center DB, Universities.
Number of physicians per 10,000 population,
1990 - 2000
45
Lithuania
Romania
Nordic c.
EU
CEE
35
25
15
1990
1992
1994
1996
1998
2000
SOURCE: WHO. (2000). Health For All Data Base (Statistical Data Base). Copenhagen: World
Health Organization Regional Office for Europe
Number of graduated physicians
per 100,000 population, 1990 - 2000
18
16
Lithuania
Romania
Nordic c.
EU
CEE
14
12
10
8
6
1990
1992
1994
1996
1998
2000
SOURCE: WHO. (2000). Health For All Data Base (Statistical Data Base). Copenhagen: World
Health Organization Regional Office for Europe
Messages:
From 8 accession countries surveyed:
Intake of students planned on demand -
4 countries
Experience in planning HHR -
limited
Unemployment of physicians -
no (exc. BUL)
From WHO and EU:
Recommendations for or coordination of
planning HHR -
absent
%
Percentage of physicians and medical residents
intending to go abroad, Lithuania, 2002
100
90
80
70
60
50
40
30
20
10
0
60.7
Physicians (497)
Residents (242)
26
14.5
5.4
Intention
Permanent stay
Reasons for leaving (physicians and residents):
Higher salary -
>70%
Higher quality of life -
>50%
Better possibilities for carrier -
>40%
Countries of interest:
Residents Nordic (Denmark, Norway, Sweden); UK; Germany.
Physicians –
Germany; UK; Nordic (Norway, Sweden, Denmark).
2 7 0 2 0 1
+ N u m
b e r
o f
p h y s i c i a n s
5 0 0
4 5 0
4 0 0
3 5 0
3 0 0
2 5 0
2 0 0
1 5 0
1 0 0
1 9 7 01 9 7 51 9 8 01 9 8 51 9 9 01 9 9 52 0 0 02 0 0 5
p
3 6 0 3 0 1
+ N u m
b e r
o f
p h y s i c i a n s
1 8
1 6
1 4
1 2
1 0
8
6
1 9 7 01 9 7 51 9 8 01 9 8 51 9 9 01 9 9 52 0 0 02 0 0 5
g
Britain to train thousands more health staff
Last Updated: 2003-02-17 10:00:43 -0400 (Reuters Health)
By Richard Woodman
LONDON (Reuters) - Thousands more training places are to be
funded for nurses, midwives and other health workers in a bid to
tackle staff shortages in the National Health Service, ministers
announced on Monday.
Health Minister John Hutton said more than £3.4 billion would be
spent over the next year supporting the learning and development
of healthcare staff, an increase of more than 12%.
By 2005/06, the budget would be £4.1 billion a year, 36% more
than now.
This includes £1.99 billion on training for nurses, allied health
professionals and healthcare scientists; £746 million for training
undergraduate medical and dental students and £1.37 billion for
doctors and dentists on specialist training.
Risk factors for intention to move abroad,
physicians
Risk factor
Male
Age (years)
Life in the city
Knowledge of English
Married / cohabiting
Visit abroad for
professional reasons
Having friends abroad
OR
1.08
0.94
1.05
1.60
1.12
1.18
95% CI
0.58-2.01
0.91-0.96
0.65-1.70
0.96-2.67
0.58-2.15
0.67-2.07
3.22
1.91-5.42
Risk factors for intention to move abroad,
residents
Risk factor
Male
Age (years)
Life in the city
Knowledge of English
Married / cohabiting
Visit abroad for professional
reasons
Having friends abroad
OR
1.21
0.97
2.04
1.90
1.59
3.29
95% CI
0.68-2.15
0.87-1.09
0.88-4.71
0.83-4.36
0.33-1.06
1.73-6.27
1.34
0.76-2.34
Planning of LTU physicians number
until 2015 based on assumptions:
Annual population growth: -0.06%
Annual drop out due to retirement: 1.92%
Annual mortality rate: 1.08%
Drop out due to other reasons: 1%
Drop out from studies: 17%
Average duration of studies: 9 years
Recommended number of physicians per 10,000
population: 33.5
Projected number of physicians per 10,000
pop. (without administrators) till 2015
38
36
34
32
30
20
14
20
12
20
10
20
08
20
06
20
04
20
02
28
20
00
Physicians per 10,000 pop.
40
Year
Student admission - 400, annual retirement 1.92%
Recommended number
Student admission - 250, annual retirement 1.92%
So what?
Is there any sense to plan HHR on the national level without
cooperation with other countries?
Who will take the initiative?
Who should be involved – universities, research, professional
associations, MoH, MoE, MoF?
Accession might have substantial impact on numbers of
physicians as well as other HHR if no cooperation will be
started.