Abstract for: System Dynamics Modeling of Health Workforce Planning to Address Future Challenges of Thailand’s Universal Health Coverage
System dynamics modeling can inform policy decisions of healthcare reforms under Thailand's Universal Health Coverage. We report on this thinking approach to Thailand’s strategic health workforce planning for the next 20 years. A series of group model building sessions involving 110 participants from multi-sectors of Thailand’s health systems were conducted in 2017 and 2018. Policymakers, healthcare administrators and practitioners were facilitated to co-create a causal loop diagram that represents a common understanding of why the demands and supplies of health workforce in Thailand can be mismatched, and a stock and flow diagrams for testing the consequences of policy options. Our model found hospital utilizations created a vicious cycle of constantly increasing demands for hospital care, and hence a constantly shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of aging populations and prevalent chronic illness. Hence, shifting an emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care and end-of-life care can be more effective. Our simulation modeling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term.