Projection of the supply of and demand for board-certified nephrologists for ESRD in Taiwan

Objective: Taiwan is the country where end-stage renal disease (ESRD) is most prevalent. The purpose of this study was to investigate whether the rising demand for dialysis or transplantation as a result of ESRD can be balanced by the supply of board-certified (B-C) nephrologists. Methods: Two Markov processes were applied for the projection of the supply of B-C nephrologists in ESRD and for the projection of the demand from ESRD in 2020, assuming linear, exponential growth and no increase. Results: The supply of B-C nephrologists was projected at 1346 in 2020. To make allowance for the share of total time of professional activities in full-time equivalent (FTE) for B-C nephrologists, the demand was 1556, 962 and 2652 with assumptions of steady, linear and exponential growth, respectively. By the year 2020, 210 and 1306 additional FTE nephrologists will be required to meet, respectively, a linear and an exponential increase in demand from ESRD. Conclusions: The projection of the supply of and the demand for B-C nephrologists was made in this study using two Markov processes. The methods and results can be adopted as a reference for health manpower planning on B-C nephrologists.