Mahboubeh Bayat
1,2, Azad Shokri
3, Elmira Mirbahaeddin
4, Roghaye Khalilnezhjad
5, Seyed Reza Khatibi
6,7, Hamed Fattahi
8, Gholamhossein Salehi Zalani
2, Faeze Ghasemi Seproo
9, Mahmoud Khodadost
2,10* 
1 Gerash University of Medical Sciences, Gerash, Iran
2 Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran
3 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
4 Telfer School of Management, University of Ottawa, Ontario, Canada
5 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
6 Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
7 Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
8 Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
9 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
10 Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
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 (14151), national hospitals survey (28898) and Continuing Medical Education registries (13159) 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 39127 (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 10000 population and ranged from 9.2 per 10000 in Tehran to 1.5 per 10000 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.