Investigating Thailand’s Public Nursing Workforce Age Structure Dynamics: A System Dynamics Approach

Abstract

The age structure of Thailand’s public nursing workforce has been evolving in an unfavorable way in the past decades. If the age structure continues to remain in this fashion, the overall healthcare system performance might deteriorate as productivity of a workforce can be influenced by its age distribution. This study investigated the problem through a systematic lens with an ultimate aim of proposing an effective policy to reshape the currently unfavorable age structure of Thailand’s public nursing workforce. A quantitative SD model was built based on literature to represent Thailand’s nursing workforce system. The model has gone through a number of validity tests and was populated with actual data obtained from statistics and existing studies to build confidence that it could serve the purpose of the study. The results of the structure-oriented analysis suggested that organizations deploying temporary employment schemes are prone to encountering the problem of age structure instability if effective employee retention measures are not in place. The simulation-based policy analysis pointed out that, in addition to the commonly suggested policy to increase the number of civil-servant positions, a complementary policy to stabilize nurse production at an optimal level is required to achieve the ideal uniform age structure suggested by Grund & Westergård-Nielsen (2008).