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金融危机对三个南欧国家卫生政策人力资源的影响。

The impact of the financial crisis on human resources for health policies in three southern-Europe countries.

作者信息

Correia Tiago, Dussault Gilles, Pontes Carla

机构信息

ISCTE-University Institute of Lisbon, Lisbon, Portugal.

Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Lisbon, Portugal.

出版信息

Health Policy. 2015 Dec;119(12):1600-5. doi: 10.1016/j.healthpol.2015.08.009. Epub 2015 Aug 20.

Abstract

The public health sector has been the target of austerity measures since the global financial crisis started in 2008, while health workforce costs have been a source of rapid savings in most European Union countries. This article aims to explore how health workforce policies have evolved in three southern European countries under external constraints imposed by emergency financial programmes agreed with the International Monetary Fund, Central European Bank and European Commission. The selected countries, Greece, Portugal and Cyprus, show similarities with regard to corporatist systems of social protection and comprehensive welfare mechanisms only recently institutionalized. Based on document analysis of the Memoranda of Understanding agreed with the Troika, our results reveal broadly similar policy responses to the crisis but also important differences. In Cyprus, General Practitioners have a key position in reducing public expenditure through gatekeeping and control of users' access, while Portugal and Greece seeks to achieve cost containment by constraining the decision-making powers of professionals. All three countries lack innovation as well as monitoring and assessment of the effects of the financial crisis in relation to the health workforce. Consequently, there is a need for health policy development to use human resources more efficiently in healthcare.

摘要

自2008年全球金融危机爆发以来,公共卫生部门一直是紧缩措施的目标,而在大多数欧盟国家,卫生人力成本一直是快速节省开支的一个来源。本文旨在探讨在与国际货币基金组织、欧洲中央银行和欧盟委员会商定的紧急金融计划所施加的外部限制下,三个南欧国家的卫生人力政策是如何演变的。选定的国家希腊、葡萄牙和塞浦路斯,在社团主义社会保护制度和直到最近才制度化的全面福利机制方面表现出相似之处。基于对与三驾马车商定的谅解备忘录的文件分析,我们的结果揭示了对危机大致相似的政策反应,但也存在重要差异。在塞浦路斯,全科医生在通过把关和控制用户就诊来减少公共支出方面具有关键地位,而葡萄牙和希腊则试图通过限制专业人员的决策权来实现成本控制。所有三个国家在与卫生人力相关的金融危机影响方面都缺乏创新以及监测和评估。因此,有必要制定卫生政策,以便在医疗保健中更有效地利用人力资源。

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