SITUATIONAL ANALYSIS OF GENERAL PRACTITIONERS USING A FORECASTING APPROACH UNTIL 2025 AND A MULTI-STATE MARKOV MODEL: A RETROSPECTIVE LONGITUDINAL STUDY

Azad Shokri; Fereshteh Farzianpour; Elmira Mirbahaeddin; Mahboubeh Bayat; Ali Akbari-Sari; Abbas Rahimi Foroushani; Iraj Harirchi; Somaieh Shokri

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SITUATIONAL ANALYSIS OF GENERAL PRACTITIONERS USING A FORECASTING APPROACH UNTIL 2025 AND A MULTI-STATE MARKOV MODEL: A RETROSPECTIVE LONGITUDINAL STUDY

Author: Azad Shokri ¹ ; Fereshteh Farzianpour ² ; Elmira Mirbahaeddin ³ ; Mahboubeh Bayat ⁴ ; Ali Akbari-Sari ² ; Abbas Rahimi Foroushani ⁵ ; Iraj Harirchi ⁶ ; Somaieh Shokri ⁷
Author Information

1. Social Determinants of Health Research Center,Research Institute for Health Development,Kurdistan University of Medical Sciences, Sanandaj, Iran.
2. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
3. Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, Ontario K1N 6N5, Canada.
4. Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran.
5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
6. Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
7. Department of Physical Education and Sport Science, Mariwan Branch, Islamic Azad University, Mariwan, Iran.
Publication Type:Journal Article
Keywords: Unemployment; Immigration; General practitioners; Iran
From:Malaysian Family Physician 2024;19(1):1-10
CountryMalaysia
Language:English
Abstract: SITUATIONAL ANALYSIS OF GENERAL PRACTITIONERS USING A FORECASTING APPROACH UNTIL 2025 AND A MULTI-STATE MARKOV MODEL: A RETROSPECTIVE LONGITUDINAL STUDY:ntroduction: Undesirable working conditions, insufficient professional development and other labour market pressures have significantly impacted the status of general practitioners (GPs). This study aimed to conduct a situational analysis of GPs in Iran using a forecasting approach until 2025. Methods: Data were collected concurrently through direct contact, data matching among databases and tracking among graduates from four clusters of medical science universities over the past decade. This retrospective longitudinal study determined the status of GPs over consecutive years. Multi-state Markov and binary logistic regression analyses were performed using R and Stata 14. Results: Of 430 graduates over the past decade, 94% were successfully identified. Only 20% of the graduates remained active as GPs. The greatest fluctuations in transfer occurred in the third year after graduation, with the remaining proportion of GPs dropping to less than 50%. The probability of remaining as GPs was 0.76 per year, while the highest transition was observed towards specialisation (0.12). Additionally, 2% of the GPs chose not to work, and less than 1% transitioned to a different specialty. Based on the transfer matrix for 2025, only 19% of the GPs were projected to remain, with the majority (59%) transitioning to specialisation. Conclusion: The transfer probability varies across different years, indicating higher flow rates among GPs. However, only a limited number of GPs are projected to remain until 2025. A comprehensive set of interventions should be considered, spanning the pre-medical stage, during education and after graduation, to mitigate the factors contributing to GPs leaving their profession.
Full text:2026102122121876471Situational analysis of general practitioners.pdf