Department of Public Health, Aarhus University, Denmark.
Department of Public Health, Aarhus University, Denmark.
Health Policy. 2024 Jan;139:104962. doi: 10.1016/j.healthpol.2023.104962. Epub 2023 Dec 13.
A cross countries in Europe, health policy is seeking to adapt to the post-pandemic 'permacrisis', where high demands on the healthcare workforce and shortages continue and combine with climate change, and war. The success of these efforts depends on the capacities of the healthcare workforce. This study aims to compare health policy responses to strengthen the capacities of the healthcare workforce and to explore the underpinning dynamics between health systems, policy actors and health policies. The study draws on a qualitative, comparative analysis of Austria, the Czech Republic, Denmark, Germany, Italy and the Netherlands. The findings suggest that policy responses at the national level focused on hospitals and absorptive capacities, while policy responses at local/regional levels also included general practice and adaptive capacities. There were only few examples of policies directed at transformative capacities. The underling dynamics were shaped by health systems, where individual parts are closely connected, by embeddedness in specific service delivery and areas, and by power dynamics. In conclusion, sub-national health policy responses emerge as key to effective responses to the post-pandemic permacrisis, where health professions are central policy actors. Sub-national health policy responses build on existing power relations, but also have the potential to transcend these power relations.
在欧洲各国，卫生政策正试图适应后疫情时代的“永久危机”，在这种危机下，医疗保健劳动力的高需求和短缺持续存在，并与气候变化和战争相结合。这些努力的成功取决于医疗保健劳动力的能力。本研究旨在比较卫生政策应对措施，以加强医疗保健劳动力的能力，并探讨卫生系统、政策行为体和卫生政策之间的潜在动态。该研究借鉴了对奥地利、捷克共和国、丹麦、德国、意大利和荷兰的定性、比较分析。研究结果表明，国家层面的政策应对措施侧重于医院和吸收能力，而地方/区域层面的政策应对措施还包括全科医生和适应能力。只有少数政策针对转型能力。潜在的动态是由卫生系统塑造的，其中各个部分紧密相连，嵌入特定的服务提供和领域，并由权力动态塑造。总之，国家以下卫生政策应对措施是对后疫情时代永久危机做出有效反应的关键，在这场危机中，卫生专业人员是核心政策行为体。国家以下卫生政策应对措施建立在现有权力关系的基础上，但也有可能超越这些权力关系。
