Université Laval and Université du Québec en Outaouais (UQO), Gatineau, Quebec, Canada.
Int J Health Plann Manage. 2019 Apr;34(2):510-520. doi: 10.1002/hpm.2712. Epub 2018 Nov 27.
Geographic imbalances in health human resources exist in a health care system when the composition, level, or use of health care providers does not lead to the same optimal health-system goals in all regions. This can lead to inequitable distribution of health care services, particularly for rural and remote populations. This study aims to determine to what extent the distribution of regulated health professionals and seniors in urban and rural areas of the Canadian jurisdictions is different from one another and from the national average. Data used in this study are for the 2016 calendar year. Information about physicians was obtained from the Canadian Institute for Health Information (CIHI) Scott's Medical Database. The data for nurses (nurse practitioners, registered nurses, and licensed practical nurses) were also sourced from CIHI, Health Workforce Database. Geographic information is based on the postal code of physicians' preferred mailing address, and the residence in the case of nurses and the population. Using the Statistical Area Classification from Statistics Canada, each physician and nurse was assigned to either an urban metropolitan, urban non-metropolitan, or rural/remote area. Findings indicate that there were twice as many nurses per 1000 seniors in urban Canada than in rural Canada. However, this gap was threefold in the case of physicians. Provinces with the largest and lowest gap and international comparisons are also provided. Three broad strategies are offered for policymakers in order to mitigate this health workforce imbalance and reduce the regional shortage of nurses and physicians.
在医疗保健系统中,如果医疗保健提供者的构成、水平或使用情况不能在所有地区实现相同的最佳健康系统目标,就会出现卫生人力资源的地理不平衡。这可能导致医疗服务的不公平分配,特别是对于农村和偏远地区的人口。本研究旨在确定加拿大司法管辖区的城市和农村地区的注册卫生专业人员和老年人的分布在多大程度上彼此不同,并且与全国平均水平不同。本研究使用的数据为 2016 日历年。有关医生的信息来自加拿大卫生信息研究所 (CIHI) 的 Scott's Medical Database。护士(执业护士、注册护士和执业护士)的数据也来自 CIHI 的卫生人力数据库。地理信息基于医生首选邮寄地址的邮政编码,以及护士和人口的居住地。使用加拿大统计局的统计区域分类,每位医生和护士都被分配到城市大都市区、城市非大都市区或农村/偏远地区。研究结果表明,加拿大城市每 1000 名老年人中有两倍的护士,而农村地区则只有三分之一。然而,在医生的情况下,这一差距是三倍。还提供了拥有最大和最小差距的省份以及国际比较。为政策制定者提供了三种广泛的策略,以缓解这种卫生人力失衡并减少护士和医生的区域短缺。