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Genova A, Lombardini S. General practitioners in front of COVID-19: Italy in European comparative perspective. FRONTIERS IN SOCIOLOGY 2024; 9:1365517. [PMID: 38846342 PMCID: PMC11153776 DOI: 10.3389/fsoc.2024.1365517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/30/2024] [Indexed: 06/09/2024]
Abstract
COVID-19 has highlighted strengths and weaknesses in healthcare systems all over the word. Despite the differences in primary care models in Europe, this study investigates the state-of-the-art of general practitioners (GPs) before the COVID-19 pandemic spread as a result of the reform process of the previous two decades. The GPs numbers over 100,000 inhabitants has been considered as a proxy of public health investment in GPs. Is the number of GPs increased or decreased in the last 20 years of reform processes in European countries? The main hypothesis is that European healthcare systems would have increased the number of GPs coherently with WHO recommendations. Comparative data on the number of GPs per 100,000 inhabitants in 21 European countries are investigated between 1995 and 2014 (the last available data). Data show that the number of family doctors over 100,000 inhabitants in European countries has increased over the last 20 years, except for Italy, where it has strongly reduced. Primary care has had a crucial role in managing the pandemic. Results of this study suggest that a country such as Italy, which has not invested in family doctors in the last two decades, would have been less equipped to manage the COVID-19 pandemic.
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Affiliation(s)
- Angela Genova
- Department of Economics, Society, Politics, University of Urbino, Urbino, Italy
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Bělobrádek J, Šídlo L, Philipp T. Influence of practice location on prescribing, diabetes care, and colorectal cancer screening among Czech general practitioners during the COVID-19 pandemic. Epidemiol Health 2024; 46:e2024033. [PMID: 38453333 PMCID: PMC11176716 DOI: 10.4178/epih.e2024033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices. METHODS We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology. RESULTS We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs). CONCLUSIONS Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.
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Affiliation(s)
- Jan Bělobrádek
- Institute of Preventive Medicine, Charles University Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | - Luděk Šídlo
- Department of Demography and Geodemography, Charles University Faculty of Science, Praha, Czech Republic
| | - Tom Philipp
- General Health Insurance Company (GHIC), Praha, Czech Republic
- Charles University, Third Faculty of Medicine, Rheumatology and Rehabilitation Clinic, Praha, Czech Republic
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Jain N, Jersovs K, Safina T, Pilmane M, Jansone-Ratinika N, Grike I, Petersons A. Medical education in Latvia: an overview of current practices and systems. Front Med (Lausanne) 2023; 10:1250138. [PMID: 37809335 PMCID: PMC10551541 DOI: 10.3389/fmed.2023.1250138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Located in northern Europe, Latvia is one of the three Baltic States with a population of 1.9 million. The country has a rich history of medical education spanning a century and is becoming an emerging global hub for medical education. Although the surge in international students has been beneficial for the development of educational and research infrastructure, increasing demands from local students, along with institutional capacity constraints, have overburdened the available resources. Substantial investments are being made to adapt to the rapidly changing geopolitical and techno-biomedical landscape. This perspective paper presents an overview of the country's medical education system, its challenges, and prospects from pre-university to doctoral level.
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Affiliation(s)
- Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
- Institute of Anatomy and Anthropology, Riga Stradinš University, Riga, Latvia
| | - Kirils Jersovs
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | - Taira Safina
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | - Mara Pilmane
- Institute of Anatomy and Anthropology, Riga Stradinš University, Riga, Latvia
| | | | - Ieva Grike
- Faculty of Residency, Riga Stradinš University, Riga, Latvia
| | - Aigars Petersons
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
- Children's Clinical University Hospital, Riga, Latvia
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Brütting C, Herget S, Bauch F, Nafziger M, Klingenberg A, Deutsch T, Frese T. Factors promoting willingness to practice medicine in rural regions and awareness of rural regions in the university's catchment area - cross-sectional survey among medical students in central Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc52. [PMID: 37560039 PMCID: PMC10407585 DOI: 10.3205/zma001634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/13/2023] [Accepted: 04/06/2023] [Indexed: 08/11/2023]
Abstract
Aim Many universities offer rural medical internships for medical students. The present survey was designed to show how rural medical work is perceived by students, whether these perceptions are associated with origin and previous experience, and how well medical students know rural regions in the vicinity of their university. In addition, students were asked how to support and inspire medical students to later work in a rural region. Methods This cross-sectional study was based on an anonymous online survey of medical students at the Universities of Halle-Wittenberg and Leipzig. The evaluations included descriptive statistics, statistical group comparisons, and qualitative content analysis of free text answers. Results A total of 882 students took part in the survey. Students who had grown up in a rural region or had lived there for a longer time (71.7% of the respondents) rated the work-life balance better (p<0.01) and the patient variety in the countryside slightly higher (p<0.05) than their fellow students from the big city. Students who had worked in a rural practice or hospital before (62.2%) rated patient diversity (p<0.001) and work variety (p<0.001), as well as workload (p<0.01), slightly higher in rural areas than students with no prior experience. On average, the specified rural model regions were still unknown to more than 60% of the students. The suggestions for attracting medical students to later work as rural physicians included financial incentives and, above all, better information about life as a rural physician and the rural regions. Conclusion Thus, the medical faculties of the universities as well as the counties threatened by medical undersupply should further expand the transfer of knowledge and experience regarding rural physician life for the students.
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Affiliation(s)
- Christine Brütting
- University of Halle-Wittenberg, Faculty of Medicine, Institute for General Medicine, Halle (Saale), Germany
| | - Sabine Herget
- University of Leipzig, Faculty of Medicine, Department of General Practice, Leipzig, Germany
| | - Felix Bauch
- University of Halle-Wittenberg, Faculty of Medicine, Institute for General Medicine, Halle (Saale), Germany
| | - Melanie Nafziger
- University of Halle-Wittenberg, Faculty of Medicine, Institute for General Medicine, Halle (Saale), Germany
| | - Anja Klingenberg
- aQua Institute for Applied Quality Improvement and Research in Health Care, Göttingen, Germany
| | - Tobias Deutsch
- University of Leipzig, Faculty of Medicine, Department of General Practice, Leipzig, Germany
| | - Thomas Frese
- University of Halle-Wittenberg, Faculty of Medicine, Institute for General Medicine, Halle (Saale), Germany
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MacVicar S, Paterson RE. Characteristics of prescribing activity within primary care in Scotland 2013–2022 of general practitioners, nurse, pharmacist and allied health prescribers: A retrospective cross‐sectional study. J Adv Nurs 2023. [DOI: 10.1111/jan.15658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/17/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
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Marciánová P, Pirožek P. The entrepreneurial orientation of general practitioners-Current theory and practice in the Czech Republic. Health Policy 2023; 131:104765. [PMID: 36963173 DOI: 10.1016/j.healthpol.2023.104765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/09/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Since 2010, the Czech Republic has been experiencing a spontaneous phenomenon in which General Practitioner (GPs) practices have been transferred to a legal limited liability company as defined by the Commercial Code. OBJECTIVES Our research attempted to ascertain the reasons that induced GPs to change their legal form, thereby opting for an entrepreneurial orientation (EO). A second objective was to measure the impact of this change on the healthcare performance of GP practices. METHODOLOGY/APPROACH We used exploratory research to examine this phenomenon in healthcare service provision. Data from 131 questionnaires was evaluated using an exploratory survey with descriptive statistics. To assess the healthcare performance of GP practices, we used secondary data from the Institute of Health Information and Statistics of the Czech Republic. FINDINGS The GPs interviewed considered their practices to be businesses. Their decision to change to a limited company form was influenced by the possibility of selling or transferring the business, employment sustainability and job security, and advantages related to cost structure and taxation. Our study shows that, in a generational exchange, the change in legal form enhances the sustainability and operation of the practice within the context of the current demands for high-quality healthcare.
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Affiliation(s)
- Pavla Marciánová
- Faculty of Economics and Administration, Masaryk University, Lipova 41a Brno, Czech Republic.
| | - Petr Pirožek
- Faculty of Economics and Administration, Masaryk University, Lipova 41a Brno, Czech Republic
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Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries. Prim Health Care Res Dev 2022; 23:e60. [PMID: 36134523 PMCID: PMC9532851 DOI: 10.1017/s1463423622000470] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: To describe variation in task shifting from GPs to practice assistants/nurses in 34 countries and to explain differences by analysing associations with characteristics of the GPs and their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill-mix of primary care teams. These developments are hampered by barriers between professional domains. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7,200 general practitioners (GPs) in 34 countries. Task shifting is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are as follows: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are as follows: demand for and supply of care, nurse prescribing, and professionalisation of practice assistants/nurses. Multilevel analysis is used to account for clustering of GPs in countries. Findings: Countries vary in the degree of task shifting. Regarding GP and practice characteristics, use of electronic health records and availability of support staff in the practice are positively associated with task shifting and GPs’ working hours negatively, in line with our hypotheses. Age of the GPs is, contrary to our hypothesis, positively related to task shifting. These variables explain 11% of the variance at GP level. Two country variables are related to task shifting: a lower percentage of practices without support staff in a country and nurse prescribing rights coincide with more task shifting. The percentage of practices without support staff has the strongest relationship, explaining 73% of the country variation.
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Taha A, Dawidowicz S, Orcel V, Puszkarek T, Bayen M, Bayen S. Relationship between training supervision and evolution of the density of GPs: a 3-year cohort study on French cities between 2018 and 2021. HUMAN RESOURCES FOR HEALTH 2022; 20:39. [PMID: 35549950 PMCID: PMC9097434 DOI: 10.1186/s12960-022-00740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
CONTEXT There is an uneven distribution of general practitioners (GPs) across territories of developed countries leading to inequalities in access to health care. Countries are implementing incentive or coercive policies depending on the characteristics of their health system. Several studies suggest that the location of practical training may influence the location of GPs' practices. The objective of this study is to investigate the existence of a relationship between training supervision and evolution of the density of GPs in French municipalities between 2018 and 2021. METHODS The evolution of the density of GPs in almost all French municipalities between 2018 and 2021 was followed up. A bivariate statistical analysis was carried out to look for a relationship between the evolution of the density of GPs and the number of training supervisors. Other bivariate analyses were carried out with other factors likely to influence the density of GPs, such as the existence of financial aid in the territory or the age of GPs. A multivariate analysis with all the significant variables in bivariate analysis was then carried out using the stepwise descending method. RESULTS A total of 34 990 (99.9%) French municipalities were included in the follow-up. Among these, 9427 (26.9%) had a GP and 3866 (11%) had a GP involved in the training supervision. The density of GPs in French cities decreased on average by 2.17% between 2018 and 2021. Territories without training supervisors decreased by 4.63% while those with at least one increased by 1.36% (p < 0.01). This significant relationship was also found in multivariate analysis. CONCLUSION The training supervision is associated with a better evolution of density of GPs in French municipalities. This association persisted when other factors were considered. The results of this 3-year follow-up may lead us to consider the training supervision as a factor to regulate the distribution of GPs.
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Affiliation(s)
- Anas Taha
- Department of General Practice, Université Paris-Est Créteil, 94000, Créteil, France.
- Maison de Santé Universitaire de Sucy-en-Brie, 5 rue Ingres, 94370, Sucy-en-Brie, France.
| | - Sébastien Dawidowicz
- Department of General Practice, Université Paris-Est Créteil, 94000, Créteil, France
- Maison de Santé Universitaire de Sucy-en-Brie, 5 rue Ingres, 94370, Sucy-en-Brie, France
| | - Véronique Orcel
- Department of General Practice, Université Paris-Est Créteil, 94000, Créteil, France
- Maison de Santé Universitaire de Sucy-en-Brie, 5 rue Ingres, 94370, Sucy-en-Brie, France
| | - Thibault Puszkarek
- Department of General Practice, Université de Bretagne Occidentale, 29200, Brest, France
| | - Marc Bayen
- Department of General Practice, Université de Lille, 59000, Lille, France
| | - Sabine Bayen
- Department of General Practice, Université de Lille, 59000, Lille, France
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Groenewegen PP, Boerma WGW, Spreeuwenberg P, Seifert B, Schäfer W, Batenburg R, van Tuyl L. Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries. Prim Health Care Res Dev 2021; 22:e66. [PMID: 34753532 PMCID: PMC8581458 DOI: 10.1017/s1463423621000657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/02/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
AIM To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. BACKGROUND Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. METHODS Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable 'task shifting' is measured through a composite score of GPs' self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. FINDINGS Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.
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Affiliation(s)
- Peter P. Groenewegen
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
- Department of Sociology and Department of Human Geography, Utrecht University, PO Box 80.115, 3508 TCUtrecht, The Netherlands
| | - Wienke G. W. Boerma
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
| | - Peter Spreeuwenberg
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
| | - Bohumil Seifert
- Institute of General Practice, Charles University, Prague, Czechia
| | - Willemijn Schäfer
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
- Northwestern University, Feinberg School of Medicine, Department of Surgery, Chicago, IL60611, USA
| | - Ronald Batenburg
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
- Department of Sociology, Radboud University, Nijmegen, The Netherlands
| | - Lilian van Tuyl
- NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BNUtrecht, The Netherlands
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Rurik I, Nánási A, Jancsó Z, Kalabay L, Lánczi LI, Móczár C, Semanova C, Schmidt P, Torzsa P, Ungvári T, Kolozsvári LR. Evaluation of primary care services in Hungary: a comprehensive description of provision, professional competences, cooperation, financing, and infrastructure, based on the findings of the Hungarian-arm of the QUALICOPC study. Prim Health Care Res Dev 2021; 22:e36. [PMID: 34193332 PMCID: PMC8278788 DOI: 10.1017/s1463423621000438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/03/2020] [Accepted: 04/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Primary health care provision in terms of quality, equity, and costs are different by countries. The Quality and Costs of Primary Care (QUALICOPC) study evaluated these domains and parameters in 35 countries, using uniformized method with validated questionnaires filled out by family physicians/general practitioners (GPs).This paper aims to provide data of the Hungarian-arm of the QUALICOPC study and to give an overview about the recent Hungarian primary care (PC) system. METHODS The questionnaires were completed in 222 Hungarian GP practices, delivered by fieldworkers, in a geographically representative distribution. Descriptive analysis was performed on the data. FINDINGS Financing is based mostly on capitation, with additional compensatory elements and minor financial incentives. The gate-keeping function is weak. The communication between GPs and specialists is often insufficient. The number of available devices and equipment are appropriate. Single-handed practices are predominant. Appointment instead of queuing is a new option and is becoming more popular, mainly among better-educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Despite the burden of administrative tasks, half of the GPs estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness, and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is insufficient; therefore, many GPs are involved in additional income-generating activities. The old age of the GPs and the lack of the younger GPs generation contributes to a shortage in manpower. Cooperation and communication between different levels of health care provision should be improved, focusing better on community orientation and on preventive services. Financing needs continuous improvement and appropriate incentives should be implemented. There is a need for specific PC-oriented guidelines to define properly the tasks and competences of GPs.
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Affiliation(s)
- Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anna Nánási
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Zoltán Jancsó
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Kalabay
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Csaba Móczár
- Irinyi Primary Care Health Center, Kecskemét, Hungary
| | - Csilla Semanova
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Péter Schmidt
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Tímea Ungvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Stobbe EJ, Groenewegen PP, Schäfer W. Job satisfaction of general practitioners: a cross-sectional survey in 34 countries. HUMAN RESOURCES FOR HEALTH 2021; 19:57. [PMID: 33906679 PMCID: PMC8077953 DOI: 10.1186/s12960-021-00604-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Job satisfaction of general practitioners (GPs) is important because of the consequences of low satisfaction for GPs, their patients and the health system, such as higher turnover, health problems for the physicians themselves, less satisfied patients, poor clinical outcomes and suboptimal health care delivery. In this study, we aim to explain differences in the job satisfaction of GPs within and between countries. METHODS We performed a secondary analysis of cross-sectional survey data, collected between 2010 and 2012 on 7379 GPs in 34 (mostly European) countries, as well as data on country and health system characteristics from public databases. Job satisfaction is measured through a composite score of six items about self-reported job experience. Operationalisation of the theoretical constructs includes variables, such as the range of services GPs provide, working hours, employment status, and feedback from colleagues. Data were analysed using linear multilevel regression analysis, with countries and GPs as levels. We developed hypotheses on the basis of the Social Production Function Theory, assuming that GPs 'produce' job satisfaction through stimulating work that provides a certain level of comfort, adds to their social status and provides behavioural confirmation. RESULTS Job satisfaction varies between GPs and countries, with high satisfaction in Denmark and Canada (on average 2.97 and 2.77 on a scale from 1-4, respectively) and low job satisfaction in Spain (mean 2.15) and Hungary (mean 2.17). One-third of the total variance is situated on the country level, indicating large differences between countries, and countries with a higher GDP per capita have more satisfied GPs. Health system characteristics are not related to GP job satisfaction. At the GP and practice level, performing technical procedures and providing preventive care, feedback from colleagues, and patient satisfaction are positively related to GP job satisfaction and working more hours is negatively related GP job satisfaction. CONCLUSION Overall and in terms of our theoretical approach, we found that GPs are able to 'produce' work-related well-being through activities and resources related to stimulation, comfort and behavioural confirmation, but not to status.
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Affiliation(s)
- Emiel J Stobbe
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands
- Trimbos Institute, Da Costakade 45, 3521VS, Utrecht, The Netherlands
| | - Peter P Groenewegen
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
- Department of Sociology, Department of Human Geography, Utrecht University, Utrecht, The Netherlands.
| | - Willemijn Schäfer
- Department of Surgery, Northwestern University, Feinberg School of Medicine, 633 N. St Clair Street, Chicago, IL, 60611, USA
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Wang L, Di X, Yang L, Dai X. Differences in the Potential Accessibility of Home-Based Healthcare Services among Different Groups of Older Adults: A Case from Shaanxi Province, China. Healthcare (Basel) 2020; 8:E452. [PMID: 33139667 PMCID: PMC7711610 DOI: 10.3390/healthcare8040452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/28/2022] Open
Abstract
With the increase of the aging population and the lack of family care, home-based healthcare services have gradually become the main model to cope with aging, so local governments have invested heavily in the construction of home-based healthcare services. However, healthcare services still have problems such as low resource utilization and imbalanced development. The reason is that the supply and demand of healthcare services are not matched and the potential accessibility is low. Therefore, based on the supply and demand of healthcare services, this article pulls out the spatial and social factors that affect the potential accessibility, and tests the influence of individual factors on the potential accessibility among different groups of older adults. It is found that the perceived vulnerability of the older adults will reduce the potential accessibility of healthcare services. The psychosocial status, income and education level with the willingness to use healthcare services of the older adults are directly proportional, while residence has a negative impact on the potential accessibility. Finally, based on this finding, this article puts forward feasible suggestions from the perspective of policy content, publicity, and implementation.
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Affiliation(s)
| | - Xiaodong Di
- School of Public Policy and Administration, Xi’an Jiaotong University, No 28 Xianning West Road, Xi’an 710049, China; (L.W.); (L.Y.); (X.D.)
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