Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
Population Health Sciences, University of Bristol, Bristol, UK.
BMJ Glob Health. 2021 Jan;6(1). doi: 10.1136/bmjgh-2020-004014.
An effective workforce is essential for optimal care of all forms of chronic diseases. The objective of this study was to assess workforce capacity for kidney failure (KF) care across world countries and regions.
Data were collected from published online sources and a survey was administered online to key stakeholders. All country-level data were analysed by International Society of Nephrology region and World Bank income classification.
The general healthcare workforce varies by income level: high-income countries have more healthcare workers per 10 000 population (physicians: 30.3; nursing personnel: 79.2; pharmacists: 7.2; surgeons: 3.5) than low-income countries (physicians: 0.9; nursing personnel: 5.0; pharmacists: 0.1; surgeons: 0.03). A total of 160 countries responded to survey questions pertaining to the workforce for the management of patients with KF. The physicians primarily responsible for providing care to patients with KF are nephrologists in 92% of countries. Global nephrologist density is 10.0 per million population (pmp) and nephrology trainee density is 1.4 pmp. High-income countries reported the highest densities of nephrologists and nephrology trainees (23.2 pmp and 3.8 pmp, respectively), whereas low-income countries reported the lowest densities (0.2 pmp and 0.1 pmp, respectively). Low-income countries were most likely to report shortages of all types of healthcare providers, including nephrologists, surgeons, radiologists and nurses.
Results from this global survey demonstrate critical shortages in workforce capacity to care for patients with KF across world countries and regions. National and international policies will be required to build a workforce capacity that can effectively address the growing burden of KF and deliver optimal care.
一支高效的医疗团队对于优化各种形式的慢性病护理至关重要。本研究旨在评估全球各国和地区在肾衰竭（KF）护理方面的劳动力能力。
数据来自已发表的在线资源和向主要利益攸关方进行的在线调查。所有国家级别的数据都根据国际肾脏病学会区域和世界银行收入分类进行了分析。
一般医疗保健劳动力的数量因收入水平而异：高收入国家每 10000 人口拥有的医疗工作者数量更多（医生：30.3；护理人员：79.2；药剂师：7.2；外科医生：3.5），而低收入国家则较少（医生：0.9；护理人员：5.0；药剂师：0.1；外科医生：0.03）。共有 160 个国家对与管理 KF 患者相关的劳动力问题的调查问题作出了回应。92%的国家中，主要负责为 KF 患者提供护理的医生是肾病学家。全球肾病学家的密度为每百万人 10.0（pmp），肾病学培训生的密度为 1.4 pmp。高收入国家报告的肾病学家和肾病学培训生密度最高（分别为 23.2 pmp 和 3.8 pmp），而低收入国家报告的密度最低（分别为 0.2 pmp 和 0.1 pmp）。低收入国家最有可能报告所有类型的医疗保健提供者（包括肾病学家、外科医生、放射科医生和护士）短缺。
这项全球调查的结果表明，全球各国和地区在肾衰竭护理方面的劳动力能力严重不足。需要制定国家和国际政策，以建立一支能够有效应对肾衰竭日益增长的负担并提供最佳护理的劳动力队伍。
