Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany.
Department of Gynecology and Obstetrics, Breast Center and CCC Munich, BZKF, University Hospital Munich, Munich Germany.
Policy Polit Nurs Pract. 2024 Nov;25(4):216-227. doi: 10.1177/15271544241286083. Epub 2024 Oct 13.
The healthcare sector is ubiquitously plagued by workforce shortages in economies around the globe. The fragility of this structural shortage becomes apparent when external shocks, such as the COVID-19 pandemic, exacerbate the lack of workers in clinical practice. In this article, we summarize current trends in healthcare workforce development across the globe, review theoretical concepts of workforce shortages, and discuss policies to address them. In practice, developed countries often address workforce shortages with targeted migration policies. However, targeted workforce migration policies only intensify workforce shortages in low-and middle-income countries. Theoretical macroeconomic models suggest that supply shortages may result from too low wages, supply lagging behind demand, and social perception. Changes in the wage rate cannot sufficiently increase the supply of health professionals as scholars find inelastic wages for physicians and nurses. Nonpecuniary factors such as working conditions, job satisfaction, and intrinsic motivation are at least equally important as financial incentives. In conclusion, increased wages can only be part of a heterogeneous policy plan to address shortages. Migration and retirement levels of health professionals can temporarily mitigate workforce shortages but rarely change the underlying systemic issues. Increasing the number of places available in medical and nursing schools while also improving, both, financial and nonfinancial incentives for employees are long-term structural policy options.
全球各国的医疗保健部门普遍面临劳动力短缺问题。当 COVID-19 大流行等外部冲击加剧临床实践中劳动力短缺时，这种结构性短缺的脆弱性就会显现出来。本文总结了全球医疗保健劳动力发展的当前趋势，回顾了劳动力短缺的理论概念，并讨论了解决这些问题的政策。在实践中，发达国家通常通过有针对性的移民政策来解决劳动力短缺问题。然而，有针对性的劳动力移民政策只会加剧中低收入国家的劳动力短缺。理论宏观经济模型表明，供应短缺可能是由于工资太低、供应跟不上需求以及社会观念造成的。工资率的变化并不能充分增加卫生专业人员的供应，因为学者们发现医生和护士的工资缺乏弹性。非经济因素，如工作条件、工作满意度和内在动机，与经济激励因素至少同样重要。总之，提高工资只能是解决短缺问题的异质政策计划的一部分。移民和卫生专业人员的退休水平可以暂时缓解劳动力短缺，但很少能改变潜在的系统性问题。增加医学和护理学校的招生名额，同时提高员工的经济和非经济激励，是长期的结构性政策选择。
