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Tackling the primary healthcare workforce crisis: time to talk about health systems and governance-a comparative assessment of nine countries in the WHO European region.

作者信息

Kuhlmann Ellen, Falkenbach Michelle, Brînzac Monica Georgina, Correia Tiago, Panagioti Maria, Rechel Bernd, Sagan Anna, Santric-Milicevic Milena, Ungureanu Marius-Ionuț, Wallenburg Iris, Burau Viola

机构信息

Institute for Economics, Labour and Culture, Goethe-University Frankfurt, Eschersheimer Landstraße 121, 60322, Frankfurt, Germany.

WHO Collaborating Center for Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal.

出版信息

Hum Resour Health. 2024 Dec 31;22(1):83. doi: 10.1186/s12960-024-00965-2.


DOI:10.1186/s12960-024-00965-2
PMID:39741313
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11686866/
Abstract

BACKGROUND: Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify capacities that may help respond effectively to the HCWF crisis in health system contexts. METHODS: A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England. RESULTS: Our findings reveal both convergence and pronounced diversity across the healthcare systems, with none fully aligning with the ideal attributes of primary healthcare suggested by WHO. However, across all categories, Denmark, the Netherlands, and to a lesser extent Kazakhstan, depict closer alignment to this model than the other countries. Workforce composition and skill-mix vary strongly, while disparities persist in education and data availability, particularly within Social Health Insurance systems. Policy responses and interventions span governance, organisational, and professional realms, although with weaknesses in the implementation of policies and a systematic lack of data and evaluation. CONCLUSIONS: Aligning primary healthcare and workforce considerations within the broader health system context may help move the debate forward and build governance capacities to improve resilience in both areas.

摘要

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本文引用的文献

[1]
"Family doctors are also people": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic.

Hum Resour Health. 2024-3-4

[2]
Healthcare workforce equity for health equity: An overview of its importance for the level of primary health care.

Int J Health Plann Manage. 2024-5

[3]
Building capacity for equitable healthcare workforce policy, learning from migrant healthcare workers: A qualitative study with Romanian physicians working in Germany during COVID-19.

Int J Health Plann Manage. 2024-7

[4]
Mapping and analysing community health worker programmes in the Eastern Mediterranean region.

Int J Health Plann Manage. 2024-5

[5]
How can intersectoral collaboration and action help improve the education, recruitment, and retention of the health and care workforce? A scoping review.

Int J Health Plann Manage. 2024-5

[6]
How can countries respond to the health and care workforce crisis? Insights from international evidence.

Int J Health Plann Manage. 2024-5

[7]
The mental health needs of healthcare workers: When evidence does not guide policy. A comparative assessment of selected European countries.

Int J Health Plann Manage. 2024-5

[8]
Moving from health workforce crisis to health workforce success: the time to act is now.

Lancet Reg Health Eur. 2023-10-26

[9]
Post-COVID health policy responses to healthcare workforce capacities: A comparative analysis of health system resilience in six European countries.

Health Policy. 2024-1

[10]
The role of Primary Health Care, primary care and hospitals in advancing Universal Health Coverage.

BMJ Glob Health. 2023-12-7

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