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Parzonka K, Ndayishimiye C, Domagała A. Methods and Tools Used to Estimate the Shortages of Medical Staff in European Countries-Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2945. [PMID: 36833641 PMCID: PMC9957245 DOI: 10.3390/ijerph20042945] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
Healthcare workforce (HWF) shortages are the biggest challenges today in healthcare systems. Therefore, it is crucial to forecast the future needs of HWFs in order to plan accordingly. The purpose of this study was to identify, map, and synthesize the tools, methods, and procedures for measuring medical staff deficits in Europe. We used the Arksey and O'Malley scoping review methodology. Based on predefined criteria, 38 publications that were retrieved from multiple scientific databases, hand-searched on the internet, from relevant organizations, and scanned from references were considered. They were published between 2002 and 2022. There were 25 empirical studies, 6 theoretical papers, 5 reports, 1 literature review, and 1 guidebook. The majority estimated or measured shortages of physicians (14/38) and nurses (7/38) or looked at HWF generally (10/38). Various methods were used, including projections, estimations, predictions, simulation models, and surveys, which used tools such as special computer software or customized indicators, i.e., the Workload Indicators of Staffing Need method. Researchers estimated HWF shortages at both national and regional levels. Such projections and estimations were often based on demand, supply, and/or need. These methods and tools are not always suited to the needs of a country or medical facility, which is why they need to be further developed and tested.
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Affiliation(s)
- Kamila Parzonka
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Costase Ndayishimiye
- Health Economics and Social Security Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska St., 31-066 Krakow, Poland
| | - Alicja Domagała
- Health Policy and Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska St., 31-066 Krakow, Poland
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MacKenzie A, MacQuarrie C, Murphy M, Piers G, Philopoulos K, Carrigan S, Joice J, Kapra J, Casault CA, MacDougall J, Langley JM, Tomblin Murphy G. Operationalizing integrated needs-based workforce planning at Nova Scotia Health in response to the COVID-19 pandemic. Healthc Manage Forum 2022; 35:222-230. [PMID: 35748087 PMCID: PMC9234379 DOI: 10.1177/08404704221093982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This paper documents Nova Scotia Health’s progress in operationalizing integrated
needs-based workforce planning as part of its ongoing response to the pandemic.
A multidisciplinary workforce planning team with representation spanning key
portfolios was created to facilitate the organization’s response to the
pandemic. Analyses applied early in Wave 3 of the pandemic showed large
projected shortages in several professions and identified which services would
likely be scarcest among the available workforce relative to patient need. Based
on these results, the workforce planning team recommended and supported
operational teams in implementing a multi-faceted set of interventions aimed at
increasing the availability of individuals with these competencies. These
interventions collectively yielded an adequate supply of additional competent
personnel to meet the needs of COVID-19 inpatients across the province through
the third wave of the pandemic. Lessons learned are proving critical to
maintaining core operations during Wave 4 of the pandemic.
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Affiliation(s)
- Adrian MacKenzie
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada.,Dalhousie University, Halifax, Nova Scotia, Canada.,WHO/PAHO Collaborating Centre on Health Workforce Planning & Research, Halifax, Nova Scotia, Canada
| | | | | | - Geoff Piers
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada
| | | | | | - Jesse Joice
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Junaid Kapra
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada
| | | | | | - Joanne M Langley
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada.,Dalhousie University, Halifax, Nova Scotia, Canada.,IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Gail Tomblin Murphy
- 432234Nova Scotia Health, Halifax, Nova Scotia, Canada.,Dalhousie University, Halifax, Nova Scotia, Canada.,WHO/PAHO Collaborating Centre on Health Workforce Planning & Research, Halifax, Nova Scotia, Canada
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MacKenzie A, Tomblin Murphy G, Audas R. A dynamic, multi-professional, needs-based simulation model to inform human resources for health planning. HUMAN RESOURCES FOR HEALTH 2019; 17:42. [PMID: 31196188 PMCID: PMC6567915 DOI: 10.1186/s12960-019-0376-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/12/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND As population health needs become more complex, addressing those needs increasingly requires the knowledge, skills, and judgment of multiple types of human resources for health (HRH) working interdependently. A growing emphasis on team-delivered health care is evident in several jurisdictions, including those in Canada. However, the most commonly used HRH planning models across Canada and other countries lack the capacity to plan for more than one type of HRH in an integrated manner. The purpose of this paper is to present a dynamic, multi-professional, needs-based simulation model to inform HRH planning and demonstrate the importance of two of its parameters-division of work and clinical focus-which have received comparatively little attention in HRH research to date. METHODS The model estimates HRH requirements by combining features of two previously published needs-based approaches to HRH planning-a dynamic approach designed to plan for a single type of HRH at a time and a multi-professional approach designed to compare HRH supply with requirements at a single point in time. The supplies of different types of HRH are estimated using a stock-and-flow approach. RESULTS The model makes explicit two planning parameters-the division of work across different types of HRH, and the degree of clinical focus among individual types of HRH-which have previously received little attention in the HRH literature. Examples of the impacts of these parameters on HRH planning scenarios are provided to illustrate how failure to account for them may over- or under-estimate the size of any gaps between the supply of and requirements for HRH. CONCLUSION This paper presents a dynamic, multi-professional, needs-based simulation model which can be used to inform HRH planning in different contexts. To facilitate its application by readers, this includes the definition of each parameter and specification of the mathematical relationships between them.
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Affiliation(s)
- Adrian MacKenzie
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada
- WHO/PAHO Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
| | - Gail Tomblin Murphy
- WHO/PAHO Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Canada
- Nova Scotia Health Authority, Halifax, Canada
| | - Rick Audas
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Silver MP, Williams SA. Reluctance to Retire: A Qualitative Study on Work Identity, Intergenerational Conflict, and Retirement in Academic Medicine. THE GERONTOLOGIST 2018; 58:320-330. [PMID: 27586874 DOI: 10.1093/geront/gnw142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/20/2016] [Indexed: 12/21/2022] Open
Abstract
Purpose of the Study Some professions foster expectations that individuals cultivate their work identity above all other aspects of life. This can be problematic when individuals are confronted with the expectation that they will readily terminate this identity in later-career stages as institutions seek to cycle in new generations. This study examines the relationship between work identity and retirement by examining multiple generations of academic physicians. Design and Methods This study used a multimethod qualitative design that included document analysis, participant observation, focus groups, and in-depth interviews with academic physicians from one of the oldest departments of medicine in North America. Results This study illustrates how participants were predisposed and then groomed through institutional efforts to embrace a career trajectory that emphasized work above all else and fostered negative sensibilities about retirement. Participants across multiple generations described a lack of work-life balance and a prioritization of their careers above nonwork commitments. Assertions that less experienced physicians were not as dedicated to medicine and implicit assumptions that later-career physicians should retire emerged as key concerns. Implications Strong work identity and tensions between different generations may confound concerns about retirement in ways that complicate institutional succession planning and that demonstrate how traditional understandings of retirement are out of date. Findings support the need to creatively reconsider the ways we examine relations between work identity, age, and retirement in ways that account for the recent extensions in the working lives of professionals.
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Affiliation(s)
- Michelle Pannor Silver
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada.,Department of Anthropology/Health Studies, University of Toronto Scarborough, Ontario, Canada
| | - Sarah A Williams
- Department of Anthropology, University of Toronto, Ontario, Canada
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Lopes MA, Almeida ÁS, Almada-Lobo B. Forecasting the medical workforce: a stochastic agent-based simulation approach. Health Care Manag Sci 2016; 21:52-75. [DOI: 10.1007/s10729-016-9379-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
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Lopes MA, Almeida ÁS, Almada-Lobo B. Handling healthcare workforce planning with care: where do we stand? HUMAN RESOURCES FOR HEALTH 2015; 13:38. [PMID: 26003337 PMCID: PMC4464124 DOI: 10.1186/s12960-015-0028-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/02/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Planning the health-care workforce required to meet the health needs of the population, while providing service levels that maximize the outcome and minimize the financial costs, is a complex task. The problem can be described as assessing the right number of people with the right skills in the right place at the right time, to provide the right services to the right people. The literature available on the subject is vast but sparse, with no consensus established on a definite methodology and technique, making it difficult for the analyst or policy maker to adopt the recent developments or for the academic researcher to improve such a critical field. METHODS We revisited more than 60 years of documented research to better understand the chronological and historical evolution of the area and the methodologies that have stood the test of time. The literature review was conducted in electronic publication databases and focuses on conceptual methodologies rather than techniques. RESULTS Four different and widely used approaches were found within the scope of supply and three within demand. We elaborated a map systematizing advantages, limitations and assumptions. Moreover, we provide a list of the data requirements necessary to implement each of the methodologies. We have also identified past and current trends in the field and elaborated a proposal on how to integrate the different methodologies. CONCLUSION Methodologies abound, but there is still no definite approach to address HHR planning. Recent literature suggests that an integrated approach is the way to solve such a complex problem, as it combines elements both from supply and demand, and more effort should be put in improving that proposal.
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Affiliation(s)
- Mário Amorim Lopes
- INESC TEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal.
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Hedden L, Barer ML, Cardiff K, McGrail KM, Law MR, Bourgeault IL. The implications of the feminization of the primary care physician workforce on service supply: a systematic review. HUMAN RESOURCES FOR HEALTH 2014; 12:32. [PMID: 24898264 PMCID: PMC4057816 DOI: 10.1186/1478-4491-12-32] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 05/26/2014] [Indexed: 05/16/2023]
Abstract
There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms 'primary care', 'women', 'manpower', and 'supply and distribution'; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted.
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Affiliation(s)
- Lindsay Hedden
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
| | - Morris L Barer
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
| | - Karen Cardiff
- School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
| | - Kimberlyn M McGrail
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
| | - Michael R Law
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3 Vancouver, BC, Canada
| | - Ivy L Bourgeault
- Telfer School of Management and Institute of Population Health, University of Ottawa, 1 Stewart St, K1N 6 N5 Ottawa, ON, Canada
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Abstract
ABSTRACTThis paper is concerned with questions relating to demographic change (population growth and aging) and its implications for operating a publicly funded health care system in a Canadian setting. It provides an assessment of how prospective population changes alone would affect the share of health care costs in total national income in Canada over the next several decades; it provides also an analysis of how actual patterns of hospital service provision changed in Ontario over the last decade in response to budgetary restrictions in a period of rising demand for services. Finally, a case is made for viewing health care as an integrated system; a description is provided of a set of computer-based models that have been developed to facilitate analysis of the health care system, and illustrative projections are discussed.
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Jeon SH, Hurley J. Physician resource planning in Canada: the need for a stronger behavioural foundation. CANADIAN PUBLIC POLICY. ANALYSE DE POLITIQUES 2010; 36:359-75. [PMID: 20939138 DOI: 10.3138/cpp.36.3.359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An effective solution to the problem of access to physician services in Canada must extend beyond an over-exclusive focus on the number of providers to consider the behaviour of physicians in greater depth. The amount of labour and associated services supplied by physicians depends importantly on their attitudes regarding work, on practice and non-practice income opportunities, and on the policy environment in which they practise. Hence, the amount of labour supplied by a given stock of physicians can change over time. Only by considering the full range of factors that affect the labour supply of physicians can we effectively plan for physician resources.
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Affiliation(s)
- Morris Barer
- Institute of Health Services and Policy Research, Canadian Institutes of Health Research, and Department of Health Care and Epidemiology, University of British Columbia, Vancouver
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O'Brien-Pallas L, Baumann A, Donner G, Murphy GT, Lochhaas-Gerlach J, Luba M. Forecasting models for human resources in health care. J Adv Nurs 2001; 33:120-9. [PMID: 11155116 DOI: 10.1046/j.1365-2648.2001.01645.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article is a review of the approaches published between 1996 and 1999 that have been used to forecast human resource requirements for nursing. Much of the work to date generally does not consider the complex factors that influence health human resources (HHR). They also do not consider the effect of HHR decisions on population health, provider outcomes such as stress, and the cost of a decision made. Supply and demand approaches have dominated. Forecasting is limited, too, by the availability of reliable and valid data bases for examining supply and use of nursing personnel across sectors. Three models--needs based, utilization based, and effective demand based--provide substantially different estimates of future HHR need. The methods of analysis employed for forecasting range from descriptive to predictive and are borrowed from demography, epidemiology, economics, and industrial engineering. Simulation models offer the most promise for the future. The forecasting methods described have demonstrated their accuracy and usefulness for specific situations, but none has proven accurate for long-term forecasting or for estimating needs for large geographical areas or populations.
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Whitcomb ME. Physician workforce planning: implications for the intensivist workforce. J Intensive Care Med 1995; 10:241-5. [PMID: 10159119 DOI: 10.1177/088506669501000506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M E Whitcomb
- Graduate Medical Education Division, American Medical Association, Chicago, IL 60610, USA
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Turner LA, Ostbye T, Pederson LL. Work force planning in the 90s, Part I: Efficiency, economy and political will--the need for a new approach. Healthc Manage Forum 1994; 6:34-40. [PMID: 10124660 DOI: 10.1016/s0840-4704(10)61119-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Critical to health services management in today's economic climate is efficient utilization of our costly and sometimes limited supply of health care professionals. This two-part article gives an overview of current issues in health care work force planning in Canada. In Part I, the problems of estimating current supply are discussed. Needs-based and demand-based forecasting are contrasted. Comprehensive needs-based planning is recommended and changes needed in order to move toward this type of planning are discussed. In Part II, the maldistribution of health care professionals and various corrective measures within the context of needs-based comprehensive planning are discussed.
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Affiliation(s)
- L A Turner
- Ministry of Health, Health Research Personnel Development Program, London, Ontario
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Barer ML, Gafni A, Lomas J. Accommodating rapid growth in physician supply: lessons from Israel, warnings for Canada. INTERNATIONAL JOURNAL OF HEALTH SERVICES 1989; 19:95-115. [PMID: 2925303 DOI: 10.2190/902t-ldfm-mq5c-ncy8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Most developing countries find themselves grappling with the implications of rapid growth in physician supply. The purpose of this article is to search for lessons or warnings for Canada (and, ultimately, elsewhere) in the manner in which Israel has chosen to accommodate its huge supply of physicians. Under extremely conservative assumptions about immigration, and assuming rates of domestic training of physicians at levels somewhat lower than at present, Canada's physician supply will continue to grow at rates in excess of general population growth for at least the next 45 years. In this article we describe the Israeli health care system from a perspective of identifying the consequences of accommodating a physician supply about 50 percent higher than that in Canada. A number of key "accommodation attributes" (low physician incomes, restricted access to hospitals for general practitioners, intramedical-professional conflicts over income and authority, a flourishing black market) are argued to be more than simply products of a unique cultural and political system, but also symptoms of a system vastly oversupplied with physicians. Early signs in Canada of similar "products" of a growing physician supply are noted. While a two-country comparison makes drawing lessons somewhat speculative, the coincidence of events suggests that these trends in Canada warrant, if not immediate action, at least careful monitoring.
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Affiliation(s)
- M L Barer
- Division of Health Services Research and Development, University of British Columbia, Vancouver, Canada
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