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EXTENDED EXECUTIVE SUMMARY      20



                 The total HRH requirement at time t, N  is given by,
                                                        rt










                 Here, N  is in the unit of Full Time Equivalent (FTE), and must be converted into headcount
                         rt
                 for gap analysis and planning purposes.

                 2.2.1  Need-based Approach


                 With the needs-based approach, the requirement of HRH is estimated based on population,
                 health care needs and have considered the following four main factors:



                 2.2.2  Service Demand Approach


                 The service demand approach in this study applied the similar factors and models as in the
                 needs-based approach. However, instead of provider’s perspective in the epidemiology and
                 level of service components, the utilisation data of healthcare services as well as service
                 coverage for diseases / conditions were used as the input data. This approach allows the
                 estimation of the HRH requirement based on the community’s perspective of health care
                 service needs.


                 2.3    Supply and Requirement Gap Analysis


                 By integrating the supply and requirement models, it is then possible to conduct a gap
                 analysis. Gap analysis is simply a comparison between the output from the supply
                 model to output from the requirement model, which is the number of HRH supply and
                 HRH requirement. The outputs are in full-time equivalent (FTE) and headcount unit. The
                 difference of HRH supply to HRH requirement over 15 years from 2016 to 2030 is calculated
                 and plotted to look at the trend and pattern of supply and requirement. In the event of
                 substantial undersupply or oversupply, possible intervention can be simulated through
                 scenario  analysis.  These analyses  involve  understanding the parameters  in each  model,
                 the impact of gaps between HRH workforce supply and requirements, and find practical
                 strategies and changes in policies to minimise the imbalance.



                 2.4    Application of System Dynamics Approach in HRH Workforce Modelling


                 Healthcare system is complex and interdependent, making the projections of HRH supply
                 and  requirements  complex  and difficult.  It was,  therefore, decided  to use the System
                 Dynamics (SD) approach for developing the HRH supply and needs-based requirement
                 projection models. SD is a collaborative simulation modelling approach that has been used
                 for many years to support  significant planning decisions in the healthcare systems worldwide
                 (Birch, 2007; CfWI, 2013b, 2013c, 2014b). It enables complex HRH workforce supply and
                 requirement to be better understood and their behaviour over time to be quantified and
                 projected using computer simulation. With SD, not only that complex processes are able to
                 be represented and integrated with the complex datasets, its ability to represent a system
                 graphically, stakeholders can readily be involved in the modelling and validation processes.
                 This study used Vensim software as a tool to build the SD-based HRH projection models.


                                                             SUPPLY AND NEEDS-BASED REQUIREMENT PROJECTIONS OF MALAYSIAN HUMAN
                                                                RESOURCES FOR HEALTH USING SYSTEM DYNAMICS APPROACH 2016 - 2030
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