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.

Valutazione Economica di un Investimento IT attraverso System Dynamics e Balanced Scorecard

Il presente lavoro di tesi si occupa di valutare, attraverso misure finanziarie, i benefici derivanti da un grosso investimento IT dell'azienda Hera. L'azienda ha deciso di investire in ERP basato su SAP per poter creare un nuovo sistema informativo integrato. Ma per calcolare dei reali benefici bisogna tener conto anche di variabili che mutano nel tempo. Per fare ciò, si è deciso di utilizzare due diversi approcci (System Dynamics e Balanced Scorecard) per arrivare alla creazione di un modello simulabile. Dopodiché è stato possibile analizzare i dati attraverso i grafici risultanti e concludere mostrando dei casi. Questi ultimi illustrano cosa succede nel caso in cui tutto sia in condizioni normali, oppure se il lavoro raddoppia, oppure non si concluda mai.