Faculty of Medicine, University Vita-Salute San Raffaele, Milan Italy.
Epidemiology of Cancer Healthcare & Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College, London, UK.
Ann Ig. 2024 Jul-Aug;36(4):392-404. doi: 10.7416/ai.2024.2602. Epub 2024 Jan 31.
Ongoing shortages in primary care doctors/primary care paediatricians and increasing healthcare needs due to ageing of the population represent a great challenge for healthcare providers, managers, and policymakers. To support planning of primary healthcare resource allocation we analyzed the geographic distribution of primary care doctors/primary care paediatricians across Italian regions, accounting for area-specific number and age of the population. Additionally, we estimated the number of primary care doctors/primary care paediatricians expected to retire over the next 25 years, with a focus on the next five years.
Ecological study.
We gathered the list of Italian general practitioners and primary care paediatricians and combined them with the data from the National Federation of Medical Doctors, Surgeons and Dentists. Using data from the National Institutes of Statistics, we calculated the average number of patients per doctor for each region using the number of residents above and under 14 years of age for general practitioners and primary care paediatricians respectively. We also calculated the number of residents over-65 and over-75 years of age per general practitioner, as elderly patients typically have higher healthcare needs.
On average the number of patients per general practitioner was 1,447 (SD: 190), while for paediatricians it was 1,139 (SD: 241), with six regions above the threshold of 1,500 patients per general practitioner and only one region under the threshold of 880 patients per paediatrician. We estimated that on average 2,228 general practitioners and 444 paediatricians are going to retire each year for the next five years, reaching more than 70% among the current workforce for some southern regions. The number of elderly patients per general practitioner varies substantially between regions, with two regions having >15% more patients aged over 65 years compared to the expected number.
over 65 years compared to the expected number. Conclusions. The study highlighted that some regions do not currently have the required primary care workforce, and the expec-ted retirements and the ageing of the population will exacerbate the pressure on the already over-stretched healthcare services. A response from healthcare administrations and policymakers is urgently required to allow equitable access to quality primary care across the country.
初级保健医生/初级保健儿科医生的持续短缺以及人口老龄化导致的医疗保健需求增加，这对医疗保健提供者、管理者和政策制定者来说是一个巨大的挑战。为了支持初级医疗保健资源配置的规划，我们分析了意大利各地区初级保健医生/初级保健儿科医生的地理分布情况，同时考虑了特定地区的人口数量和年龄结构。此外，我们还估算了未来 25 年内预计退休的初级保健医生/初级保健儿科医生数量，重点关注未来五年。
生态研究。
我们收集了意大利全科医生和初级保健儿科医生的名单，并将其与全国医学、外科和牙医联合会的数据相结合。利用国家统计局的数据，我们分别计算了每个地区的每个医生对应的平均患者数量，其中普通科医生对应的是 14 岁以上和 14 岁以下居民的数量，初级保健儿科医生对应的是 14 岁以下居民的数量。我们还计算了每一位全科医生对应的 65 岁以上和 75 岁以上居民的数量，因为老年患者通常有更高的医疗保健需求。
平均而言，每位普通科医生对应的患者数量为 1447 人（标准差：190），而儿科医生对应的患者数量为 1139 人（标准差：241），有六个地区的每位普通科医生对应的患者数量超过 1500 人，只有一个地区的每位儿科医生对应的患者数量低于 880 人。我们估计，未来五年内，平均每年将有 2228 名全科医生和 444 名儿科医生退休，在某些南部地区，这一数字将超过现有劳动力的 70%。每个地区的每位全科医生对应的老年患者数量差异很大，有两个地区的 65 岁以上患者比预期数量多 15%以上。
与预期数量相比。结论。这项研究表明，一些地区目前没有足够的初级保健劳动力，预计的退休人员和人口老龄化将使本已紧张的医疗服务系统面临更大的压力。医疗保健管理部门和政策制定者急需做出回应，以确保全国各地都能公平获得高质量的初级保健服务。
