Gastroenterologische und hepatologische Versorgung in Österreich – eine Gap-Analyse

Background Due to the high burden of disease, the field of gastroenterology and hepatology plays a significant role in health provision in Austria, yet it is underrepresented in research and planning. The aim of the study is to determine the current level of demand and supply and to forecast capacity needs up to the year 2030. Methods In order to depict the current supply and demand, data from five administrative sources are analysed. Future demand is forecast based on current supply and demand by means of a gap analysis, in which the current status is projected to 2030 using a stock–flow model on the supply side and a translation of utilisation into physician capacities on the demand side. Results In 2021, the supply side is characterized by a large share of specialists above the age of 54 years, especially among specialists working outside of hospitals (i.e., have an “Österreichischen Gesundheitskasse” [ÖGK] contract), who will partially or completely retire by 2030, thus resulting in a high demand for graduates with relevant specialist training. At the same time, the forecast assumes an annual increase in demand of 0.8% to 2.4%. According to the gap analysis, at least 78 specialists will be needed in hospital care and between 144 and 188 specialists with ÖGK contracts. In addition, there is an unknown demand for physicians with (1) dual employment (employed and self-employed without ÖGK contract), (2) contract with other health insurance funds or (3) private practices. Over the same period, about 240 graduates are expected, who merely will cover the required capacity of the two calculated groups. Conclusion Our analysis suggests a considerable gap between trained gastroenterologists and future demand. Our demand calculations do not even include colonoscopy screening rolled out in all Austrian states. In addition, demographic change may lead to a shortage of trainers and thus make it even harder to keep output of specialists at today’s level.