Geographic Distribution of Active Medical Specialists in Iran: A Three-Source Capture-Recapture Analysis

Background: Estimation of health workforce supply becomes problematic when there is no knowledge about the number of active specialists. The aim of this study is to estimate active specialists and their geographic accessibility in Iran. Methods: We enrolled all medical specialists from the Iranian Ministry of Health database (14 151), national hospitals survey (28 898) and Continuing Medical Education registries (13 159) in 2015. Duplicate records across the three registries were identified based on the similarity of national ID codes and medical council codes. The number of active medical specialists was estimated by three-source capture-recapture method using Stata 12 software. Results: A total of 33,416 specialists were identified from three sources. We estimated the number of specialists at 39 127 (95% CI: 38823.6-39448.4) in 2015. Of these, 45.4% pertained to the province of Tehran while only less than 1.8% of specialists were in the provinces of Ilam (0.50%), South Khorasan (0.56%) and Kohgiloye and Boyerahmad (0.59%). The estimated ratio for specialists was 4.9 per 10 000 population and ranged from 9.2 per 10 000 in Tehran to 1.5 per 10 000 population in Sistan and Balochestan. The overall completeness of data registries by three sources was 85.4%. Conclusion: The current distribution of specialists appears to be imbalanced. It is suggested to adopt appropriate policies to improve the distribution and maintenance of medical specialists in different parts of Iran.