Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
Nova National School of Public Health and Comprehensive Health Research Center, Nova University of Lisbon, Lisbon, Portugal.
Hum Resour Health. 2023 Jul 14;21(1):55. doi: 10.1186/s12960-023-00842-4.
Primary care services are key to population health and for the efficient and equitable organisation of national health systems. This is why they are often financed through public funds. Primary care doctors are instrumental for the delivery of preventive services, continuity of care, and for the referral of patients through the system. These cadres are also the single largest health expenditure at the core of such services. Although recruitment and retention of primary care doctors have always been challenging, shortages are now exacerbated by higher demand for services from aging populations, increased burden of chronic diseases, backlogs from the COVID-19 pandemic, and patient expectations. At the same time, the supply of primary care physicians is constrained by rising retirement rates, internal and external migration, worsening working conditions, budget cuts, and increased burnout. Misalignment between national education sectors and labour markets is becoming apparent, compounding staff shortages and maldistribution. With their predominantly publicly funded health systems and in the aftermath of COVID-19, countries of the European region appear to be now on the cusp of a multi-layered, slow-burning primary care crisis, with almost every country reporting long waiting lists for doctor appointments, shortages of physicians, unfilled vacancies, and consequently, added pressures on hospitals' Accident and Emergency services. This articles collection aims at pulling together the evidence from countries of the European Region on root causes of such workforce crisis, impacts, and effectiveness of existing policies to mitigate it. Original research is needed, offering analysis and fresh insights into the primary care medical workforce crisis in wider Europe. Ultimately, the aim of this articles collection is to provide an evidence basis for the identification of policy solutions to present and future primary health care crises in high as well as lower-income countries.
初级保健服务是人口健康的关键，也是国家卫生系统高效和公平组织的关键。这就是为什么它们通常通过公共资金来提供资金。初级保健医生在提供预防服务、提供医疗连续性以及通过系统转诊患者方面发挥着重要作用。这些人员也是此类服务核心的最大单一卫生支出。尽管招聘和留住初级保健医生一直具有挑战性，但由于人口老龄化导致对服务的需求增加、慢性病负担增加、COVID-19 大流行积压、以及患者期望，短缺问题现在更加严重。与此同时，初级保健医生的供应受到退休率上升、内部和外部移民、工作条件恶化、预算削减以及倦怠增加的限制。国家教育部门和劳动力市场之间的不匹配变得明显，加剧了人员短缺和分布不均的问题。欧洲区域的国家拥有主要由公共资金资助的卫生系统，并且在 COVID-19 之后，似乎正处于多层次、缓慢燃烧的初级保健危机的边缘，几乎每个国家都报告说医生预约等待时间长、医生短缺、职位空缺未填补，因此给医院的急症服务带来了额外的压力。本文章集旨在汇集欧洲区域各国有关这种劳动力危机的根本原因、影响以及现有缓解政策的有效性的证据。需要进行原始研究，为更广泛的欧洲初级保健医疗劳动力危机提供分析和新的见解。最终，本文章集的目的是为高收入和低收入国家当前和未来的初级卫生保健危机确定政策解决方案提供证据基础。
