Belgian Health Care Knowledge Centre (KCE), Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium.
Hum Resour Health. 2010 Dec 8;8:28. doi: 10.1186/1478-4491-8-28.
Planning human resources for health (HRH) is a complex process for policy-makers and, as a result, many countries worldwide swing from surplus to shortage. In-depth case studies can help appraising the challenges encountered and the solutions implemented. This paper has two objectives: to identify the key challenges in HRH planning in Belgium and to formulate recommendations for an effective HRH planning, on the basis of the Belgian case study and lessons drawn from an international benchmarking.
In Belgium, a numerus clausus set up in 1997 and effective in 2004, aims to limit the total number of physicians working in the curative sector. The assumption of a positive relationship between physician densities and health care utilization was a major argument in favor of medical supply restrictions. This new regulation did not improve recurrent challenges such as specialty imbalances, with uncovered needs particularly among general practitioners, and geographical maldistribution. New difficulties also emerged. In particular, limiting national training of HRH turned out to be ineffective within the open European workforce market. The lack of integration of policies affecting HRH was noteworthy. We described in the paper what strategies were developed to address those challenges in Belgium and in neighboring countries.
Planning the medical workforce involves determining the numbers, mix, and distribution of health providers that will be required at some identified future point in time. To succeed in their task, health policy planners have to take a broader perspective on the healthcare system. Focusing on numbers is too restrictive and adopting innovative policies learned from benchmarking without integration and coordination is unfruitful. Evolving towards a strategic planning is essential to control the effects of the complex factors impacting on human resources. This evolution requires an effective monitoring of all key factors affecting supply and demand, a dynamic approach, and a system-level perspective, considering all healthcare professionals, and integrating manpower planning with workforce development.
To engage in an evidence-based action, policy-makers need a global manpower picture, from their own country and abroad, as well as reliable and comparable manpower databases allowing proper analysis and planning of the workforce.
卫生人力资源规划（HRH）对于政策制定者来说是一个复杂的过程，因此，世界上许多国家的卫生人力资源规划都经历了从过剩到短缺的转变。深入的案例研究可以帮助评估所遇到的挑战和实施的解决方案。本文有两个目标：一是确定比利时 HRH 规划中的关键挑战，二是根据比利时案例研究和国际基准比较得出的经验教训，为有效的 HRH 规划提出建议。
在比利时，1997 年设立并于 2004 年生效的医师人数上限政策旨在限制从事治疗性医疗行业的医生总数。假设医生密度与医疗保健利用率之间存在正相关关系，是支持医疗供应限制的主要论据。这项新规定并没有改善反复出现的挑战，例如专业失衡，特别是在普通科医生方面存在未满足的需求，以及地理分布不均。新的困难也出现了。特别是，限制国内人力资源培训在开放的欧洲劳动力市场中效果不佳。政策对人力资源的影响缺乏整合也是值得注意的。本文描述了在比利时和邻国为应对这些挑战而制定的战略。
规划医疗劳动力队伍需要确定在未来某个确定的时间点所需的卫生提供者的数量、组合和分布。为了成功完成任务，卫生政策规划者必须从更广泛的角度看待医疗保健系统。关注数量过于局限，采用从基准比较中学习的创新政策而不进行整合和协调是没有成效的。向战略规划转变对于控制影响人力资源的复杂因素的影响至关重要。这种转变需要有效监测所有影响供需的关键因素，采取动态方法，从系统层面考虑所有医疗保健专业人员，并将人力规划与劳动力发展相结合。
为了采取基于证据的行动，政策制定者需要了解本国和国外的全面人力资源情况，以及可靠和可比的人力资源数据库，以便对劳动力进行适当的分析和规划。
