How much specialist capacity does a disease require? Disease-attributable hospital activity and FTE from national claims data
PhD candidate: Marc Heinle
Capacity in Dutch hospital care is planned per specialty, while demand arises per disease. How much medical-specialist time, and therefore how much FTE, a given disease accounts for is not currently known. This project builds that estimate from ten years of national Dutch medical-specialist claims (2015–2024), covering essentially the whole insured population.
Four steps that are usually collapsed into a single number are kept apart. Accounting: apportioning national specialist time and FTE across disease groups. Decomposition: splitting the growth in activity, time and spending into population size, ageing, the number of people treated, and what happens per patient. Attribution: estimating how much of the hospital care of people with a disease is associated with the disease itself rather than with who those people are, by comparing them against reweighted comparison populations. Conversion: turning activity counts into clinician time and into a share of national specialist capacity. Type 2 diabetes serves as the worked case; the aim is coverage of all disease groups.
Methodologically the project draws on econometric and health-economic approaches to decomposition and to comparing populations that differ systematically, applied at national scale to data describing realised rather than required care.
The intended contribution is threefold: a disease-level picture of where national specialist time actually goes, a basis for translating epidemiological change — ageing, rising prevalence, prevention — into specialist workforce terms, and a transferable method that other diseases and other claims-based health systems can apply.
