Kuhlmann E, Lauxen O, Larsen C
Institute for Economics, Labour and Culture, Goethe University Frankfurt, Frankfurt, Germany.
Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden.
Hum Resour Health. 2016 Nov 28;14(1):71. doi: 10.1186/s12960-016-0170-3.
As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play.
The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance. The monitor applies an approach from the European Network on Regional Labour Market Monitoring to the health workforce. The novel aspect of this model is an integrated, procedural approach that promotes a 'learning system' of governance based on three interconnected pillars: mixed methods and bottom-up data collection, strong stakeholder involvement with complex communication tools and shared decision- and policy-making. Selected empirical examples illustrate the approach and the tools focusing on two aspects: the connection between sectoral, occupational and mobility data to analyse skill/qualification mixes and the supply-demand matches and the connection between monitoring and stakeholder-driven policy.
Regional health workforce monitoring can promote effective governance in high-income countries like Germany with overall high density of health workers but maldistribution of staff and skills. The regional stakeholder networks are cost-effective and easily accessible and might therefore be appealing also to low- and middle-income countries.
随着卫生人力政策的发展势头不断增强，欧盟及国际上的数据来源和监测系统有了显著改善。然而，数据与政策制定及实施之间的联系仍然薄弱，往往无法充分支持综合方法。这凸显了治理的重要性以及创新的必要性。
本案例研究介绍了德国莱茵兰 - 普法尔茨州的区域卫生人力监测情况，并试图探索监测在创新卫生人力治理方面的能力。该监测采用了欧洲区域劳动力市场监测网络的方法应用于卫生人力领域。该模式的新颖之处在于一种综合的程序方法，它基于三个相互关联的支柱促进一种“学习型治理系统”：混合方法和自下而上的数据收集、通过复杂的沟通工具让利益相关者深度参与以及共享决策和政策制定。选定的实证例子说明了该方法和工具，重点关注两个方面：部门、职业和流动数据之间的联系，以分析技能/资格组合和供需匹配情况，以及监测与利益相关者驱动的政策之间的联系。
区域卫生人力监测可以促进像德国这样卫生工作者总体密度高但人员和技能分布不均的高收入国家的有效治理。区域利益相关者网络具有成本效益且易于获取，因此可能对低收入和中等收入国家也具有吸引力。
