Projected supply of physicians with no reform

medical assistants or technicians than to nurses engaged in patient care (data are from 2018 cross-sectional data; see the Saudi Health council balanced distribution data Set 2018). Given this important difference in categorization, simulations to determine the percentage of bachelor and advanced nurses out of the total nursing cadre were conducted; these findings are presented in chapter 6. note that data on physicians incorporate both generalists and specialists—the classifications of whom are similar to international professional standards—and a small portion of dentists. The physician data and classification obviated the need for any additional adjustments for worker numbers.

To enable comparison with estimated supply changes associated with policy interventions, projected estimates of health worker numbers were additionally adjusted for worker productivity, yielding a full-time equivalent employee estimate. Additional steps to include worker productivity are discussed in chapter 6. The adjusted full-time equivalent supply of health workers is also presented in chapter 6.

The methodology outlined relies on historical trends in worker supply, building on previous work by the Saudi commission for Health Specialties. In its report, The State of the Health Saudi Workforce over the Next Ten Years 2018–2027 (ScfHS 2017), the supply of physicians and nurses from 2017 to 2027 was estimated from data on numbers of medical and nursing students. The stock-andflow model assumed a set attrition rate for each cadre, varying only by worker nationality (foreign versus Saudi). However, there are additional paths for entry to and exit from the labor force—immigration, death and retirement, change in employment to and from nonhealth sectors—that should also be accounted for in such an approach, but doing so may be challenging because of data availability. The methodology used in the present study accounts for the net total of these flows into and out of the health workforce by implicitely assuming that historical worker numbers reflect labor market equilibrium. In other words, whereas ScfHS (2017) projects forward the output of education institutions and makes assumptions about graduation rates and attrition out of the labor market, the growth rate aproach incorporates production output and exit by projecting forward the past trend of physicians and nurses already employed in the health labor market.

The status quo baseline projections presented in this chapter also assume that entry and exit patterns remain constant, and no other policy intervention that may change the historical trend in supply and productivity. details on the data and methods underlying the projections can be found in annex 4A. In chapter 6, the historical trend in supply and productivity is further examined. In the simulated scenarios in chapter 7, these assumptions are relaxed; the impact of policy interventions (for example, delayed retirement, Saudization of the workforce, increased productivity) on health workforce supply are evaluated.

PROJECTED SUPPLY OF PHYSICIANS WITH NO REFORM

Without policy change, the number of Saudi physicians will double by 2030, and may be even higher when taking physicians in the non-MOH public sector into account. figure 4.2 shows that, based on past trends, the number of Saudi physicians will increase from 23,463 in 2020 to 42,019 in 2030—a 79 percent increase. The Saudi physician density per 1,000 population is projected to change