比较全球重大卫生危机期间的卫生人力政策：批判性概念性辩论和国际经验调查。
Comparing Health Workforce Policy during a Major Global Health Crisis: A Critical Conceptual Debate and International Empirical Investigation.
机构信息
Clinic for Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30265 Hannover, Germany.
Sociology of Health and Health Systems, Faculty I, University of Siegen, Adolf-Reichwein-Strasse 1, 57068 Siegen, Germany.
出版信息
Int J Environ Res Public Health. 2023 Mar 13;20(6):5035. doi: 10.3390/ijerph20065035.
BACKGROUND
The health workforce is central to healthcare systems and population health, but marginal in comparative health policy. This study aims to highlight the crucial relevance of the health workforce and contribute comparative evidence to help improve the protection of healthcare workers and prevention of inequalities during a major public health crisis.
METHODS
Our integrated governance framework considers system, sector, organizational and socio-cultural dimensions of health workforce policy. The COVID-19 pandemic serves as the policy field and Brazil, Canada, Italy, and Germany as illustrative cases. We draw on secondary sources (literature, document analysis, public statistics, reports) and country expert information with a focus on the first COVID-19 waves until the summer of 2021.
RESULTS
Our comparative investigation illustrates the benefits of a multi-level governance approach beyond health system typologies. In the selected countries, we found similar problems and governance gaps concerning increased workplace stress, lack of mental health support, and gender and racial inequalities. Health policy across countries failed to adequately respond to the needs of HCWs, thus exacerbating inequalities during a major global health crisis.
CONCLUSIONS
Comparative health workforce policy research may contribute new knowledge to improve health system resilience and population health during a crisis.
背景
卫生人力是医疗体系和人口健康的核心，但在比较卫生政策中却处于边缘地位。本研究旨在强调卫生人力的重要性，并提供比较证据，以帮助在重大公共卫生危机期间保护医护人员和预防不平等。
方法
我们的综合治理框架考虑了卫生人力政策的系统、部门、组织和社会文化维度。COVID-19 大流行是政策领域，巴西、加拿大、意大利和德国是说明性案例。我们利用二手资料（文献、文件分析、公共统计、报告）和国家专家信息，重点关注 2021 年夏季前的第一波 COVID-19 疫情。
结果
我们的比较研究说明了多层次治理方法超越卫生系统类型学的好处。在所选择的国家中，我们发现了类似的问题和治理差距，包括工作场所压力增加、缺乏心理健康支持以及性别和种族不平等。各国的卫生政策未能充分满足卫生工作者的需求，从而在重大全球卫生危机期间加剧了不平等。
结论
比较卫生人力政策研究可以为改善危机期间的卫生系统弹性和人口健康提供新知识。
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