Lopes Mário Amorim, Almeida Álvaro Santos, Almada-Lobo Bernardo
INESC TEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal.
Faculdade de Economia, Universidade do Porto, Porto, Portugal.
Hum Resour Health. 2015 May 24;13:38. doi: 10.1186/s12960-015-0028-0.
Planning the health-care workforce required to meet the health needs of the population, while providing service levels that maximize the outcome and minimize the financial costs, is a complex task. The problem can be described as assessing the right number of people with the right skills in the right place at the right time, to provide the right services to the right people. The literature available on the subject is vast but sparse, with no consensus established on a definite methodology and technique, making it difficult for the analyst or policy maker to adopt the recent developments or for the academic researcher to improve such a critical field.
We revisited more than 60 years of documented research to better understand the chronological and historical evolution of the area and the methodologies that have stood the test of time. The literature review was conducted in electronic publication databases and focuses on conceptual methodologies rather than techniques.
Four different and widely used approaches were found within the scope of supply and three within demand. We elaborated a map systematizing advantages, limitations and assumptions. Moreover, we provide a list of the data requirements necessary to implement each of the methodologies. We have also identified past and current trends in the field and elaborated a proposal on how to integrate the different methodologies.
Methodologies abound, but there is still no definite approach to address HHR planning. Recent literature suggests that an integrated approach is the way to solve such a complex problem, as it combines elements both from supply and demand, and more effort should be put in improving that proposal.
规划满足人群健康需求所需的医疗人力,同时提供能使成果最大化且财务成本最小化的服务水平,是一项复杂的任务。这个问题可描述为在正确的时间、正确的地点评估拥有正确技能的正确人数,以便为正确的人群提供正确的服务。关于该主题的现有文献数量众多但较为零散,在确定的方法和技术上尚未达成共识,这使得分析师或政策制定者难以采用最新进展,学术研究人员也难以改进这一关键领域。
我们回顾了60多年来有记录的研究,以更好地理解该领域的时间顺序和历史演变以及经受住时间考验的方法。文献综述在电子出版物数据库中进行,重点关注概念性方法而非技术。
在供给范围内发现了四种不同且广泛使用的方法,在需求范围内发现了三种。我们精心制作了一张地图,将优势、局限性和假设进行了系统化整理。此外,我们提供了实施每种方法所需的数据要求清单。我们还确定了该领域过去和当前的趋势,并就如何整合不同方法提出了建议。
方法众多,但在解决卫生人力规划问题上仍没有明确的方法。近期文献表明,综合方法是解决此类复杂问题的途径,因为它结合了供给和需求两方面的要素,应投入更多努力来完善这一建议。