A healthcare workforce assessment model using reimbursement data in Luxembourg

Abstract Background The assessment of the healthcare professional (HCP) headcount and level of activity is a real challenge for policy makers. In Luxembourg, there is no uniform definition of practicing HCP. This work focused on identifying a method to assess HCP headcount and their level of activity in Luxembourg, while finding national consensus. Methods A thorough literature review was conducted to find methods that assess practicing HCP and identify their level of activity. Eligible were scientific papers or national reports discussing methods on employed and self-employed HCP. National reimbursement data were used for preliminary data explorations conducted alongside the ‘General Inspectorate of Social Security’ in Luxembourg and discussed with the ‘Institut national d’assurance maladie-invalidité (INAMI)’ in Belgium. Two working groups were planned with national stakeholders to discuss HCP assessment methodologies. Both the collaborations and the working groups led to a preliminary validated HCP assessment method. To reach national consensus, a Delphi study is planned in June 2024, using the eDelphi.org platform. Invited panelists include researchers, professionals, healthcare practitioners, decision makers and policy makers, patient representatives, and insurers. Results The literature review found 16 eligible papers on HCP headcount and HCP’ level of activity. Finally, the Belgian method, developed by experts from INAMI, using reimbursement data and establishing a median reimbursement for each medical specialty was retained for Luxembourg. The results of the Delphi study will inform on the level of agreement on relevance, clarity and completeness of the proposed methodology for Luxembourg. Discussion Finding national consensus represents a strong foundation for efforts to advance the use of the proposed methodology in healthcare workforce assessment and planning. Key messages • Counting something as simple as healthcare professionals requires a strong methodology that held the buy-in of all major stakeholder. • As working behavior of HCP evolves over time, it is crucial to not only count professionals but also full-time equivalents for policy makers to plan ahead in an accurate manner.