Modelling the Future Malaysian Clinician Dental Workforce using System Dynamics
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Abstract
Introduction: The aim of this operational research workforce project was to build, and test, a clinical dental work- force model for Malaysia to address population need/demand with a view to informing health policy. Methods: A system dynamics (SD) model was developed to take account of population oral health needs and demands and dental workforce supply nationally from 2010 to 2040. This involved building two sub-models: population need/de- mand; and dental workforce supply, drawing on evidence from two previous studies (student survey and interviews of key-stakeholders) supported by government data. The two sub-models were integrated in relation to clinical time to explore potential of over- or under-supply of clinical hours; were latter converted to clinical workforce numbers. The SD model was tested and validated as an acceptable baseline model for Malaysia using existing workforce data. Results: A SD model was developed to model the need, supply and demand for dental care in two sectors from 2010 to 2040. There is a short-term need for an expanded dental workforce to meet the needs of the population but there is a potential oversupply of dentists and therapists from 2040, or earlier. The level of public demand for both primary and secondary dental care is expected to increase respectively from the year 2010 to 2040, varying in relation to demographic and health trends across public and private sectors. Conclusion: The study suggests there is are current requirements for an expanded dental workforce to serve the population needs/demand and potential for oversupply from 2040, or earlier.
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Kuhlmann E, Batenburg R, Dussault G. Health workforce governance in Europe: Where are we going? Health Policy. 2015;119(12):1515-6. doi: 10.1016/j.healthpol.2015.10.008.
WHO. Models and tools for health workforce planning and projections. Geneva: World Health Organization; 2010.
GHWA and WHO. Health Workforce 2030: A global strategy on human resources for health. Geneva: World Health Organization; 2015.
Deliege D. Imbalances in medical manpower: Recent evolution and practices in Europe. In: Bankowski Z, Mejia A, editors. Health manpower out of balance: Conflicts and prospects. Geneva: Council for International Organizations of Medical Sciences (CIOMS); 1987. p. 124-52.
Hornby P. Exploring the Use of the World Health Organization Human Resources for Health Projection Model 2007 [Available from: http://www.capacityproject.org/workforce_ planningworkshop/presentations/WHO.hornby. ppt
HEE. Health Education England Strategic Framework 2014 - 2029. Health Education England; 2015.
Gallagher JE, Wilson NHF. The future dental workforce? British Dental Journal. 2009;206(4):195- 99. doi: 10.1038/sj.bdj.2009.114.
Che Musa MF, Bernabe E, Gallagher JE. The dental workforce in Malaysia: drivers for change from the perspectives of key stakeholders. Int Dent J. 2020;70(5):360–73. doi: 10.1111/idj.12575
Gallagher JE. Health Futures Study of Facial, Oral and Dental Surgery in London: University of London; 2002.
Garreth M. Health Future Handbook. Geneva: World Health Organization; 1999.
Burgersdijk R, Brokhurst E, Truin G. Future Scenarios on Dental Health Care. A Reconnaissance of the Period 1990-2020 London: Kluwer Academic Publishers; 1994.
Wanyonyi KL. The delivery of primary dental care team in a training enviroment through team working: implications for dental skill mix in England: King’s College London Dental Institute; 2015.
Ghotane SG, Don-Davis P, Kamara D, Harper PR, Challacombe SJ, Gallagher JE. Needs-led human resource planning for Sierra Leone in support of oral health. Hum Resour Health. 2021;19(1):106. doi: 10.1186/s12960-021-00623-x.
Tiwari R, Bhayat A, Chikte U. Forecasting for the need of dentists and specialists in South Africa until 2030. PLoS One. 2021;16(5):e0251238. doi: 10.1371/journal.pone.0251238
Murat AN. Estimating oral health needs and worforce requirements using sociodental and skill mix approaches: University College London (UCL); 2012.
De Silva MDK. Dental workforce planning for Sri Lanka: University of Southampton; 2012.
Doughan CB, Kassak K, Bourgeois D. Planning dental manpower in Lebanon: scenario for 2015. Eastern Mediterranean Health Journal. 2005;11(5- 6):943-51.
Pidd M. Why modelling and model use matter. Journal of the Operational Research Society. 2010;61(1):14-24. doi: 10.1057/jors.2009.141
Davis JP, Eisenhardt KM, Bingham CB. Developing theory through simulation methods. Academy of Management Review. 2007;32(2):480-99. doi: 10.5465/AMR.2007.24351453
Banks J, CarsonII JS, Nelson BL, Micol DM. Discrete-Event System Simulation. 3rd ed. Upper Saddle River, New Jersey: Prentice Hall; 2001.
Tako AA. Development and use of simulation models in Operational Research: a comparison of discrete-event simulation and system dynamics: University of Warwick; 2008.
Sterman JD. Business Dynamics : Systems Thinking And Modeling For The Complex World. Boston: McGraww-Hill; 2000.
Van Greuningen M, Batenburg RS, Van der Velden LF. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example. Hum Resour Health. 2012;10(1):21. doi: 10.1186/1478-4491-10-21
Lancet T. Migration of health workers: An unmanaged crisis. Lancet. 2005;365(9474):1825.
McGrail MR, Humphreys JS, Joyce CM. Nature of association between rural background and practice location: a comparison of general practitioners and specialists. BMC Health Serv Res. 2011;11:63. doi: 10.1186/1472-6963-11-63.
Che Musa MF, Bernabe E, Gallagher JE. Students’ motivation to study dentistry in Malaysia: An analysis using confirmatory factor analysis. Human Resource for Health. 2015;13(1):47. doi: 10.1186/ s12960-015-0040-4.
Che Musa MF, Bernabe E, Gallagher JE. Career expectations and influences among dental students in Malaysia. International Dental Journal. 2016; 66(4):229-236. doi: 10.1111/idj.12224.
Luna-Reyes LF, Andersen DL. Collecting and analyzing qualitative data for system dynamics: methods and models. System Dynamics Review. 2003;19(4):271-96. doi: 10.1002/sdr.280
Grytten J, Carlsen F, Sorensen R. Supplier inducement in a public health care system. J Health Econ. 1995;14(2):207-29. doi: 10.1016/0167- 6296(94)00036-4
Office of National Statistics. National Children’s Dental Health Survey 2003: National Archives; 2004 [Available from: http://webarchive. nationalarchives.gov.uk/+/www.dh.gov. uk/en/Publicationsandstatistics/Bulletins/ Chiefdentalofficersbulletin/Browsable/ DH_4860753.
Public Health England. What is Known About the Oral Health of Older People in England and Wales: A review of oral health surveys of older people. 2015.
Oral Health Division Malaysia. National Oral Health Survey of School Children 2007 (NOHSS 2007): 16 year olds. Putrajaya: OHD, Ministry of Health Malaysia; 2010.
Department of Statistics Malaysia. Report of the Population Projections of Malaysia 2010-2040. Putrajaya: Department of Statistics; 2012.
Cohen DW. Improving oral healthcare delivery. Compend Contin Educ Dent. 2011;32(2):96.
Marcenes W, Kassebaum NJ, Bernabe E, Flaxman A, Naghavi M, Lopez A, et al. Global burden of oral conditions in 1990-2010: A systematic analysis. J Dent Res. 2013;92(7):592-7. doi: 10.1177/0022034513490168.
Oral Health Division Malaysia. Annual Report 2012. Putrajaya: OHD, Ministry of Health Malaysia; 2013.
UNESCO and Malaysia. Education for all 2015: National review. World Education Forum; 2015.
Zakaria NA, Ab-Murat N, Che Musa MF, Johari MZ. A Study on Parental Acceptance Towards
the Use of Dental Therapists in Malaysian Private Sectors Malaysian Journal of Medicine and Health Sciences. 2020;16(4):13-20.
Oral Health Division Malaysia. National Oral Health Survey of Adults 2010 (NOHSA 2010). Putrajaya: OHD, Ministry of Health Malaysia 2013.
Ghotane SG, Al-Haboubi M, Kendall N, Robertson C, Gallagher JE. Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London. BMC Oral Health. 2015;15(1):110. doi: 10.1186/s12903-015-0085-8.
Milling L. A grand history of dental hyginiests 2013 [Available from: http://www.rdhmag.com/articles/ print/volume-30/issue-7/features/a-grand-history. html.
Schulz M, Kunst AE, Brockmann H. High educational attainment moderates the association between dental health-care supply and utilization in Europe. Eur J Oral Sci. 2016;124(1):52-61. doi: 10.1111/eos.12237.
Institute for Public Health. National Health and Morbidity Survey 2011. Kuala Lumpur: Ministry of Health Malaysia; 2012.
Rashid H, Manoharan A, Abufanas S, Gallagher J. Motivation for a career in dentistry: The views of dental students in the United Arab Emirates. International Dental Journal. 2013;63(5):259-65. doi: 10.1111/idj.12043.
Asthana A. Generation Y: They don’t live for work ... they work to live: The Guardian; 2008 [Available from: http://www.guardian.co.uk/money/2008/ may/25/workandcareers.worklifebalance.
Ministry of Higher Education Malaysia. Dental Education in Malaysia: Journey towards excellence. Putrajaya: MOHE; 2010.
Malaysian Dental Council. Malaysian Dental Council Bulletin. 2013.
Malaysian Dental Council. Reduction of Compulsory Service Period Cyberjaya: MDC; 2015.
Segal L, Bolton T. Issues facing the future health care workforce: the importance of demand modelling. Aust New Zealand Health Policy. 2009;6:12.
OECD. Health at a Glance 2011: OECD Indicators: Organisation for Economic Co-operation and Development 2011. Available from: http://www. oecd.org/els/health-systems/49105858.pdf.