Forecasting the need for medical specialists in Spain: application of a system dynamics model

[EN] Background: Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities. Methods: We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method. Results: In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology. Conclusions: The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America.

¿Donde reutilizar y qué regar?: uso de un sig para el diseño de una red de reutilización en una isla volcánica

[ES] El conocimiento de criterios que ayuden a priorizar el uso del agua es fundamental para garantizar su uso sostenible. En las zonas semiáridas, el abandono de la actividad agrícola puede estar motivado por la escasez de agua y por problemas de mercado de las especies tradicionalmente cultivadas. Por otro lado, la actividad ganadera, suele estar limitada por la escasez de forrajes. La disponibilidad de agua regenerada a un precio razonable podría evitar su vertido y contrarrestar la degradación de suelos abandonados, potenciando la producción de especies forrajeras rentables, contribuyendo así a la ganadería sostenible. Para ello se requiere optimizar la distribución del agua considerando varios criterios simultáneamente