A new model for optimization of diabetes clinics with the case study in Iran

J Diabetes Metab Disord. 2022 Jan 6;21(1):817-822. doi: 10.1007/s40200-021-00939-4. eCollection 2022 Jun.

Abstract

Objective: This study presented a new model for optimal assignment of human resources to 3-level defined clinics to improve the management of diabetes.

Methods: First, the data of population and prevalence of diabetes and data about complications were gathered. Then, the number of needed visits was calculated for different classes of diabetic people using guidelines. On the supply side, the maximum number of available visits for a given year by a given specialty was calculated. Two scenarios were considered. The first scenario calculated the number of needed specialties to cover the guideline needs, while the second real-world scenario used human resource data to optimize the assignment of human resources to different levels of clinics.

Results: The highest and lowest required specialties per year are 2780 General practitioners (GPs) and 492 gastroenterologists. Seven hundred forty-one endocrinologists or internists are required each year to cover all the needs. The highest and lowest number of the available specialties were 4967 GPs and 35 nutritionists. 81% of cities can cover basic services, while even the lowest level of coverage is not possible in 19% of districts.

Conclusions: The present study's findings advise the policymakers to train human resources based on available evidence and distribute the human resources based on an evidence-based model. This could be achieved using the private section resources.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-021-00939-4.

Keywords: Complications; Diabetes mellitus; Management; Optimal model; The healthcare system.