(0209) Defining a Global Otolaryngology Workforce Target

Introduction: The otolaryngology-head and neck surgery (OHNS) workforce plays an essential role in addressing the burden of otolaryngologic conditions, which affect millions worldwide. However, the global OHNS clinician workforce is thought to be insufficient to provide comprehensive care for all patients. This study aims to identify a minimum density of OHNS clinicians that can be used as a target for workforce policy and capacity-building.

Methods: This study used otolaryngology clinician density from the 114 countries represented in the Global OHNS Initiative workforce survey. National estimates of laryngeal cancer incidence and mortality were drawn from the Global Burden of Disease study. Mortality-to-Incidence Ratios (MIR) were used to assess the effectiveness of national cancer control. Human Development Index values provided insight into the socioeconomic context of each country. The analysis employed a segmented regression model to estimate the optimal OHNS clinician density. The target density was determined by the breakpoint in the relationship between OHNS workforce density and laryngeal cancer 1-MIR.

Results: The adjusted segmented regression model identified a breakpoint of 2.77 OHNS clinicians per 100,000 population. Beyond this threshold, the incremental benefit of adding clinicians diminished. When compared against the workforce survey data, there was a deficit of 72,979 OHNS clinicians among represented countries. Regional and income group disparities were evident, particularly in sub-Saharan Africa and low and middle income countries (LMICs).

Conclusions: This study addresses a critical gap in understanding the minimum density of OHNS clinicians required for comprehensive care. The identified target density of 2.77 OHNS clinicians per 100,000 population serves as a starting point for further country-level research and a benchmark for future workforce planning and advocacy efforts. The significant global workforce deficit underscores the urgency of expanding OHNS training, particularly in LMICs, to ensure equitable access to OHNS care globally