RESUMEN
Burnout and workforce attrition present pressing global challenges in healthcare, severely impacting the quality of patient care and the sustainability of health systems worldwide. Artificial intelligence (AI) has immense potential to reduce the administrative and cognitive burdens that contribute to burnout through innovative solutions such as digital scribes, automated billing and advanced data management systems. However, these innovations also carry significant risks, including potential job displacement, increased complexity of medical information and cases, and the danger of diminishing clinical skills. To fully leverage AI's potential in healthcare, it is essential to prioritise AI technologies that align with stakeholder values and emphasise efforts to re-humanise medical practice. By doing so, AI can contribute to restoring a sense of purpose, fulfilment and efficacy among healthcare workers, reinforcing their essential role as caregivers, rather than distancing them from these core professional attributes.
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Inteligencia Artificial , Agotamiento Profesional , Personal de Salud , Humanos , Agotamiento Profesional/prevención & control , Personal de Salud/psicología , Fuerza Laboral en SaludRESUMEN
This study aims to promote the system construction of public health talent through understanding the status and identifying problems of public health human resources in Weihai City. A survey on professional public health institutions was conducted through questionnaires and interviews in Weihai City, and statistical analysis on the personnel structure, introduction, and turnover of professional public health institutions was conducted. There were 24 professional public health institutions in Weihai City, with a vacancy rate of 44.27% (1 367/3 088). Health professionals accounted for 68.09% (1 669/2 451) of the on-duty personnel. The number of health technicians in professional public health institutions in the city was 0.57 per thousand people. Among the 1 669 health professionals, the age groups≤35, 36-45, 46-54, and ≥55 accounted for 47.63% (795/1 669), 30.26% (505/1 669), 18.10% (302/1 669), and 4.01% (67/1 669), respectively. The personnel with bachelor's degrees and master's degrees accounted for 74.60% (1 245/1 669) and 8.09% (135/1 669). The personnel holding clinical medical, nursing, laboratory, and public health qualifications accounted for 61.34% (995/1 622), 28.30% (459/1 622) and 10.36% (168/1 622), respectively. Only 17.73% (296/1 669) of personnel held deputy senior or above technical titles, while 45.96% (767/1 669) held junior or below technical titles. About 70.10% (1 170/1 669) personnel held permanent positions, and 29.90% (499/1 669) held non-permanent positions. From 2021 to 2023, the employment rate of public health institutions was 65.51% (207/316), and the ratio of introduced and lost personnel was approximately 3â¶2 (207/132).
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Salud Pública , Humanos , Encuestas y Cuestionarios , China , Adulto , Persona de Mediana Edad , Personal de Salud , Recursos Humanos , Fuerza Laboral en Salud/estadística & datos numéricos , Femenino , MasculinoRESUMEN
AIM OF THIS STUDY: General internal medicine is a crucial element in healthcare systems. Understanding how many people are and will be working in this field is important to maintain and improve quality for patients in healthcare systems. This can provide a basis for political decisions. METHODS: We conducted a cross-sectional study to analyse the current and future workforce of generalists (general practitioners and internists in hospitals) in Switzerland. The Swiss Society of General Internal Medicine (SSGIM) distributed a survey to all members. Respondents were asked about their current average workload in 2023 and planned workload in 2033. The responses were used to calculate full-time equivalent (FTE) for the current and future workforce of generalists and to extrapolate FTE for all active SSGIM members. To model the demand by 2033, we derived different scenarios. RESULTS: Of all 6,232 active SSGIM members, 2,030 (33%) participated: 46% female, 25% (largest age group) 56-65 years old, 19% still in postgraduate training. The average workload in 2023 was 78% for female and 87% for male generalists; the FTE extrapolated to all active SSGIM members in 2023 was 5,246. By 2033, 1,935 FTEs (36%) will retire, 502 FTEs (10%) will reduce their workload, 116 FTEs (2%) will increase their workload and 2,800 FTEs (53%) will remain in the workforce with the same workload as in 2023. To maintain the same workforce as in 2023, 2,321 new FTEs (44%) will be needed by 2033. To fill this gap of 232 FTE new generalists per year, we modelled different scenarios with assumptions of interest, workload, migration and dropouts. CONCLUSIONS: Within only one decade, 44% of the current workforce of generalists will disappear, mainly due to retirement and decreased workload. To fill this gap, various scenarios need to be incorporated. Politicians are called upon to create the political framework to create attractive training and working conditions for generalists to address the future demand for healthcare services.
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Médicos Generales , Medicina Interna , Carga de Trabajo , Humanos , Suiza , Estudios Transversales , Femenino , Masculino , Medicina Interna/estadística & datos numéricos , Carga de Trabajo/estadística & datos numéricos , Persona de Mediana Edad , Médicos Generales/provisión & distribución , Médicos Generales/estadística & datos numéricos , Encuestas y Cuestionarios , Anciano , Adulto , Fuerza Laboral en Salud/estadística & datos numéricos , Fuerza Laboral en Salud/tendencias , Recursos Humanos/estadística & datos numéricosRESUMEN
Background: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology. Objective: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census. Methods: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles. Results: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35-54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological. Conclusions: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology.
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Censos , Fuerza Laboral en Salud , Humanos , Persona de Mediana Edad , Femenino , Masculino , Adulto , Fuerza Laboral en Salud/estadística & datos numéricos , Rol Profesional , Encuestas y Cuestionarios , Especialización/estadística & datos numéricos , Salud Global , Australia , Nueva ZelandaRESUMEN
There are well-documented shortages of healthcare providers in rural and remote communities worldwide, and these shortages correlate with inequitable health outcomes for rural peoples. Despite a wide array of efforts to remedy the issue, these shortages persist to this day. The Healthcare Traveling Roadshow (HCTRS) is a grassroots initiative that began in 2010 to help address the shortage of healthcare providers in rural communities throughout British Columbia. Since its inception, the HCTRS has been predicated on three evidence-based guiding principles which have been shown to markedly increase the rate at which healthcare students choose to practice rurally. These principles are: (1) to showcase healthcare careers as viable and realistic options for rural youth (high school students) using interactive stations and near-peer teaching; (2) to expose healthcare students to rural communities and showcase them as a potential opportunity for their future practice; and (3) to provide a unique interprofessional experience to healthcare students from diverse healthcare careers and backgrounds. Through the synergy of these three principles the HCTRS aims to increase the longitudinal recruitment and retention of healthcare workers in underserved rural communities. This paper will share our experience from 15 years of running this initiative, for those hoping to implement similar programs in other areas of the world.
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Selección de Profesión , Servicios de Salud Rural , Población Rural , Humanos , Adolescente , Colombia Británica , Personal de Salud/educación , Fuerza Laboral en SaludRESUMEN
BACKGROUND: Ensuring that the scale and hierarchical structure of health human resources are rational, and that medical services are efficient and fair, is an important task of practical significance. On this basis, examining the impact of health human resources on the level of medical services presents a new and formidable challenge. This study aims to delve into how the scale and hierarchical structure of health human resources in China's four major economic regions affect the fairness and efficiency of medical services, and to identify optimization strategies. METHODS: This study utilizes provincial panel data from China's four major economic regions spanning the years 2009 to 2021. Initially, it provides a statistical description of the current state of health human resources and the level of medical services. Subsequently, it employs a fixed-effects model to analyze the impact of the scale and hierarchical structure of health human resources, as well as their interactive effects, on the fairness and efficiency of medical services, and discusses the interactive mechanisms between medical service fairness and medical service efficiency. Furthermore, after conducting a comprehensive evaluation of the level of medical services using the entropy weight method, it explores the regional heterogeneity and temporal dynamics in the influence of the scale and hierarchical structure of health human resources on the level of medical services. Finally, the study examines the scientific validity and rationality of the research findings through various robustness checks, including the substitution of research variables and models. RESULTS: The study found that the scale of health human resources has a promoting effect on the equity of medical services (ß ≤ 0.643, p ≤ 0.01), but exhibits an inhibitory effect on the efficiency of medical services (ß ≥ -0.079, p ≤ 0.1); the hierarchical structure of health human resources shows a positive impact on both the equity and efficiency of medical services (ßequity ≤ 0.160, p ≤ 0.01; ßefficiency ≤ 0.341, p ≤ 0.05); at the same time, the results indicate that the interactive effect of the scale and hierarchical structure of health human resources promotes equity in medical services (ß = 0.067, p ≤ 0.01), but restricts the efficiency of medical services (ß ≥ -0.039, p ≤ 0.01); the mechanism by which health human resources affect the level of medical services in China's western and northeastern regions is more pronounced than in the central and eastern regions; after the implementation of the "Healthy China 2030" Planning Outline, the role of health human resources in the level of medical services has been strengthened; in the robustness tests, the model remains robust after replacing the core explanatory variables, with R2 maintained between 0.869 and 0.972, and the dynamic GMM model test shows a significant second-order lag in the level of medical services (ßequity ≤ 0.149, p ≤ 0.01; ßefficiency ≤ 0.461, p ≤ 0.01); the channel test results prove that managerial personnel and other technical personnel are key pathways in regulating the impact of medical staff on the level of medical services. CONCLUSION: This study provides an in-depth analysis of the impact of health human resources on the level of medical services, revealing that both the scale and hierarchical structure of health human resources significantly affect the equity and efficiency of medical services. Furthermore, the influence of health human resources on the level of medical services exhibits regional heterogeneity and temporal characteristics. Robustness tests ensure the scientific validity and robustness of the research conclusions. This provides effective references for optimizing the allocation of health human resources and improving the level of medical services.
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Fuerza Laboral en Salud , China , Humanos , Recursos en Salud , Servicios de Salud/economía , Servicios de Salud/normas , Atención a la Salud/economíaRESUMEN
BACKGROUND: Aboriginal Community Controlled Health Services (ACCHSs) in Australia aim to optimise access to comprehensive and culturally safe primary health care (PHC) for Aboriginal populations. Central to quality service provision is the retention of staff. However, there is lack of published research reporting patterns of staff turnover and retention specific to ACCHSs. This study quantified staff turnover and retention in regional and remote ACCHSs in the Northern Territory (NT) and Western Australia (WA), and examined correlations between turnover and retention metrics, and ACCHSs' geographical and demographic characteristics. METHODS: The study used 2017-2019 payroll data for health workers in 22 regional and remote PHC clinics managed by 11 ACCHSs. Primary outcome measures included annual turnover and 12-month stability rates, calculated at both clinic and organisation levels. RESULTS: There was a median of five client-facing (Aboriginal health practitioners, allied health professionals, doctors, nurses/midwives, and 'other health workers' combined) and two non-client-facing (administrative and physical) staff per remote clinic, at any timepoint. Mean annual turnover rates for staff were very high, with 151% turnover rates at the clinic level and 81% turnover rates at the organisation level. Mean annual turnover rates for client-facing staff were 164% and 75%, compared to 120% and 98% for non-client-facing staff, at clinic and organisational levels, respectively. Mean 12-month stability rates were low, with clinic-level stability rates of only 49% and organisation-level stability rates of 58%. Mean annual clinic-level turnover rates were 162% for non-Aboriginal staff and 81% for Aboriginal staff. Both workforce metrics were moderately to highly correlated with the relative remoteness of clinics, size of regular clients serviced, and average annual headcount of employees in each clinic (p values < 0.01). CONCLUSIONS: Participating ACCHSs in remote NT and WA have very high turnover and low retention of healthcare staff. Overall, clinic-level turnover rates increase as distance from regional centres increases and are lower for Aboriginal staff, suggesting that greater employment of Aboriginal staff could help stabilise staffing. Improved retention could reduce burden on ACCHSs' resources and may also support quality of service delivery due to improved cultural safety and continuity of care.
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Servicios de Salud del Indígena , Nativos de Hawái y Otras Islas del Pacífico , Reorganización del Personal , Humanos , Reorganización del Personal/estadística & datos numéricos , Northern Territory , Australia Occidental , Servicios de Salud del Indígena/estadística & datos numéricos , Servicios de Salud Rural , Femenino , Fuerza Laboral en Salud/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Servicios de Salud Comunitaria/estadística & datos numéricos , MasculinoRESUMEN
Using novel national data, we examined the association between 2020 federal COVID-related funding targeted to health centers (i.e., H8 funding) and health center workforce and operational capacity measures that may be important for preserving patient access to care and staff safety. We assigned health centers to quartiles based on federal funding distribution per patient and used adjusted linear probability models to estimate differences in workforce and operational capacity outcomes across quartiles from April 2020 to June 2022. We found a nearly 6-fold difference in 2020 H8 funding per patient when comparing health centers in the lowest versus highest quartiles. Despite this difference, health centers' outcomes improved similarly across quartiles over time, with the lowest-funded health centers having the greatest staffing and service capacity challenges. Our findings suggest that COVID-related health center funding may have contributed to stabilization of health centers' workforce and operations. Amid concerns about staff turnover, sustained investments targeted to supporting workforce retention at health centers can help to ensure ongoing delivery of critical services.
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COVID-19 , COVID-19/epidemiología , Humanos , Estados Unidos , SARS-CoV-2 , Financiación Gubernamental , Fuerza Laboral en Salud , Recursos Humanos , PandemiasRESUMEN
BACKGROUND: In 1993, WHO declared tuberculosis (TB) as a global health emergency considering 10 million people are battling TB, of which 30% are undiagnosed annually. In 2020 the COVID-19 pandemic took an unprecedented toll on health systems in every country. Public health staff already engaged in TB control and numerous other departments were additionally tasked with managing COVID-19, stretching human resource (HR) capacity beyond its limits. As part of an assessment of HR involved in TB control in India, The World Bank Group and partners conducted an analysis of the impact of COVID-19 on TB human resources for health (HRH) workloads, with the objective of describing the extent to which TB-related activities could be fulfilled and hypothesizing on future HR requirements to meet those needs. METHODS: The study team conducted a Workload Indicators and Staffing Needs (WISN) analysis according to standard WHO methodology to classify the workloads of priority cadres directly or indirectly involved in TB control activities as over-, adequately or under-worked, in 18 districts across seven states in India. Data collection was done via telephone interviews, and questions were added regarding the proportion of time dedicated to COVID-19 related tasks. We carried out quantitative analysis to describe the time allocated to COVID-19 which otherwise would have been spent on TB activities. We also conducted key informant interviews (KII) with key TB program staff about HRH planning and task-shifting from TB to COVID-19. RESULTS: Workload data were collected from 377 respondents working in or together with India's Central TB Division (CTD). 73% of all respondents (n = 270) reported carrying out COVID-19 tasks. The average time spent on COVID-19 tasks was 4 h / day (n = 72 respondents). Multiple cadres highly instrumental in TB screening and diagnosis, in particular community outreach (ASHA) workers and CBNAAT/TrueNAAT laboratory technicians working at peripheral, block and district levels, were overworked, and spending more than 50% of their time on COVID-19 tasks, reducing time for TB case-finding. Qualitative interviews with laboratory technicians revealed that PCR machines previously used for TB testing were repurposed for COVID-19 testing. CONCLUSIONS: The devastating impact of COVID-19 on HR capacity to conduct TB case-finding in India, as in other settings, cannot be overstated. Our findings provide clear evidence that NTEP human resources did not have time or essential material resources to carry out TB tasks during the COVID pandemic without doing substantial overtime and/or compromising on TB service delivery. To minimize disruptions to routine health services such as TB amidst future emerging infectious diseases, we would do well, during periods of relative calm and stability, to strategically map out how HRH lab staff, public health resources, such as India's Health and Wellness Centers and public health cadre, and public-private sector collaboration can most optimally absorb shocks to the health system.
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COVID-19 , SARS-CoV-2 , Tuberculosis , Carga de Trabajo , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , India/epidemiología , Tuberculosis/epidemiología , Tuberculosis/terapia , Tuberculosis/prevención & control , Personal de Salud , Fuerza Laboral en Salud/organización & administración , Pandemias/prevención & controlRESUMEN
INTRODUCTION: Shifting demographics, an aging population, and increased healthcare needs contribute to the global healthcare worker shortage. Migrant Health Care Workers (MHCWs) are crucial contributors to reducing this shortage by moving from low-and middle-income countries (LMICs) to high-income countries (HICs) for better opportunities. Economic factors and health workforce demand drive their migration, but they also face challenges adapting to a new country and new working environments. To effectively address these challenges, it is crucial to establish evidence-based policies. Failure to do so may result in the departure of Migrant Healthcare Workers (MHCWs) from host countries, thereby worsening the shortage of healthcare workers. AIM: To review and synthesize the barriers experienced by MHCWs as they adjust to a new country and their new foreign working environments. METHODOLOGY: We followed the PRISMA guidelines and conducted a search in the PubMed and Embase databases. We included cross-sectional studies published after the year 2000, addressing MHCWs from LMIC countries migrating to high-income countries, and published in English. We established a data extraction tool and used the Appraisal tool for Cross-Sectional Studies (AXIS) to assess article quality based on predetermined categories. RESULTS: Through a targeted search, we identified fourteen articles. These articles covered 11,025 MHCWS from low- to medium-income countries, focusing on Europe, the USA, Canada, Australia, New Zealand, and Israel. Participants and respondents' rates were diverse ranging from 12% to 90%. Studies encompassed various healthcare roles and age ranges, mainly 25-45 years, with a significant female presence. Participants resided in host countries for 3-10 years on average. Results are categorized based on the Riverside Acculturation Stress Inventory (RASI) and expanded to include bureaucratic and employment barriers, Gender differences, Natives vs. non-natives, and orientation programs. CONCLUSIONS: The findings emphasize the importance of cultural competence training and tailored support for MHCWs integration and job satisfaction. Time spent in the new healthcare setting and the influence of orientation programs are key factors in shaping their intentions to stay or leave. Despite limitations, these studies provide valuable insights, emphasizing the ongoing need for holistic strategies to facilitate successful integration, ultimately benefiting healthcare systems and well-being for all stakeholders.
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Personal de Salud , Migrantes , Humanos , Países Desarrollados , Países en Desarrollo , Aculturación , Fuerza Laboral en Salud , Lugar de Trabajo , Australia , CanadáRESUMEN
Objectives: The Swiss Cohort of Healthcare Professionals and Informal Caregivers (SCOHPICA) was created to study the career trajectories, retention intentions, and wellbeing of healthcare professionals (HCPs), addressing challenges such as staff turnover, low job satisfaction and burnout. Methods: SCOHPICA is a prospective open cohort. An electronic questionnaire was used to collect data from HCPs across multiple healthcare settings in Switzerland, encompassing the intention to stay in the profession, wellbeing, and various organizational, psychosocial, occupational and sociodemographic determinants. Results: The first (2022) baseline sample included 1707 HCPs from over 20 professions. Notably, 13% did not intend to stay in their profession, with intermediate caregivers (24%), registered nurses (17%) and pharmacists (17%) reporting the highest rates. Pharmacists scored lowest in wellbeing. Across determinants, pharmacists, physicians, and registered nurses reported worse scores for workload and work-life balance. Nursing professions had lower scores in various determinants, including influence at work, staffing and resource adequacy, and possibilities for development. Conclusion: SCOHPICA will provide critical insights on HCPs' work conditions and experiences, supporting health workforce monitoring and management, and informing policy-making to ensure high-quality healthcare delivery.
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Agotamiento Profesional , Cuidadores , Personal de Salud , Satisfacción en el Trabajo , Reorganización del Personal , Carga de Trabajo , Humanos , Masculino , Femenino , Suiza , Personal de Salud/psicología , Cuidadores/psicología , Adulto , Estudios Prospectivos , Persona de Mediana Edad , Encuestas y Cuestionarios , Reorganización del Personal/estadística & datos numéricos , Agotamiento Profesional/epidemiología , Carga de Trabajo/psicología , Fuerza Laboral en SaludRESUMEN
BACKGROUND: Mental, neurological, and substance abuse (MNS) disorders describe a range of conditions that affect the brain and cause distress or functional impairment. In the Middle East and North Africa (MENA), MNS disorders make up 10.88 percent of the burden of disease as measured in disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) is one of the main providers of mental health services and one of the largest contributors to mental health research in the region. Within the past decade, mental health resources and services has increased. METHODS: We employ a needs-based workforce estimate as a planning exercise to arrive at the total number of psychiatrists, nurses, and psychosocial care providers needed to meet the epidemiological need of mental health conditions of the population of KSA. Estimates for a potential mental health workforce gap were calculated using five steps: Step 1-Quantify target population for priority mental health conditions. Step 2-Identify number of expected cases per year. Step 3-Set target service coverage for each condition. Step 4-Estimate cost-effective health care service resource utilization for each condition. Step 5-Estimate service resources needed for each condition. RESULTS: The planning exercise indicates an epidemiologic need for a total of 17,100 full-time-equivalent (FTE) health care providers to treat priority MNS disorders. KSA appears to have a need-based shortage of 10,400 health workers to treat mental disorders. A total of 100 psychiatrists, 5700 nurses, and 4500 psychosocial care providers would be additionally needed (that is, above and beyond current levels) to address the priority mental health conditions. The shortfall is particularly severe for nurses and psychosocial workers who make up 98.9 percent of the shortfall. This shortage is substantial when compared to other high-income countries. Overall, the workforce needed to treat MNS conditions translates to 49.2 health workers per 100,000 population. CONCLUSION: Challenges to addressing the shortfall are Saudi specific which includes awareness of cultural customs and norms in the medical setting. These challenges are compounded by the lack of Saudi nationals in the mental health workforce. Saudi nationals make up 29.5 percent of the physician workforce and 38.8 percent of the nursing workforce. Policymakers and planners supplement this shortfall with non-Saudi providers, who must be mindful of Saudi-specific cultural considerations. Potential solutions to reducing the shortfall of mental health care workers includes nurse task shifting and training of general practitioners to screen for, and treat, a subset of MNS disorders.
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Necesidades y Demandas de Servicios de Salud , Fuerza Laboral en Salud , Trastornos Mentales , Servicios de Salud Mental , Humanos , Arabia Saudita , Trastornos Mentales/terapia , Psiquiatría , Enfermeras y Enfermeros/provisión & distribución , Análisis Costo-Beneficio , Recursos Humanos , Recursos en Salud/provisión & distribución , Personal de Salud/psicologíaRESUMEN
AIM: The aim of this study was to update and project the growth of ophthalmologists in New Zealand. This will help decision makers better understand the current ophthalmologist workforce and make appropriate resource allocations. METHOD: Supply and demographics of ophthalmologists in New Zealand were obtained from the Medical Council of New Zealand, Health Workforce New Zealand and Health New Zealand - Te Whatu Ora. Ophthalmology trainee numbers were extracted from the annual reports of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). New Zealand population statistics were extracted from the Stats NZ database. A simulation model was developed to project the growth of ophthalmologists from 2024 to 2050. RESULTS: In March 2023, there were 175 practising ophthalmologists in New Zealand. Overall, there were 34.0 ophthalmologists per million population, with 201.4 ophthalmologists per million for those aged ≥65 years. To maintain the current ratio, an additional 20 practising ophthalmologists are needed by 2050. CONCLUSION: The ratio of ophthalmologists per million population aged ≥65 years is projected to drop by 1.5% annually. To meet the demand of an increasing and ageing population, and RANZCO's goal of 40 ophthalmologists per million population, there needs to be an increase in ophthalmologist training positions from the current 5-year average of 6.6 to 11 new trainees annually, and a more effective distribution of the ophthalmologist workforce.
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Oftalmólogos , Oftalmología , Nueva Zelanda , Humanos , Oftalmólogos/estadística & datos numéricos , Oftalmólogos/provisión & distribución , Oftalmología/educación , Oftalmología/estadística & datos numéricos , Predicción , Anciano , Fuerza Laboral en Salud/tendencias , Fuerza Laboral en Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Recursos Humanos/estadística & datos numéricosRESUMEN
ABSTRACT: The COVID-19 pandemic drastically affected health care delivery for vulnerable populations. Many facilities shifted services to telemedicine, and people with HIV or at risk of acquiring HIV experienced interruptions in care. Simultaneously, traditional training approaches to help providers adapt were disrupted. Using a mixed method approach to examine changes over time, we integrated data on trainee needs collected by the Mountain West AIDS Education and Training Center (AETC): a 10-state needs assessment survey in 2020; feedback from a 2020 community of practice; aggregate training data from 2000 to 2022; and a second survey in 2022. HIV care providers' training needs evolved from wanting support on telemedicine and COVID-19 patient care issues, to a later focus on mental health and substance use, social determinants of health, and care coordination. This integrative analysis demonstrates the vital role that AETCs can play in addressing evolving and emergent public health challenges for the HIV workforce.
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COVID-19 , Infecciones por VIH , Personal de Salud , Evaluación de Necesidades , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Infecciones por VIH/epidemiología , Personal de Salud/educación , Telemedicina , Fuerza Laboral en Salud , Estados Unidos/epidemiología , Pandemias , Atención a la Salud/organización & administración , Necesidades y Demandas de Servicios de Salud , Encuestas y Cuestionarios , Femenino , MasculinoRESUMEN
Due to remarkable advancements in medications, more people are living longer with human immunodeficiency virus (HIV). The HIV workforce has been strained by a supply-demand mismatch, threatening the care of an aging population with multiple comorbidities. Solving the HIV workforce shortage requires multiple novel and creative solutions that recruit new trainees to the field, increase the workforce diversity, and improve disparities in access to care. New and expanded models of care that incorporate a wider array of clinicians and optimize the use of team-based care will also be crucial.
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Infecciones por VIH , Humanos , Infecciones por VIH/epidemiología , Fuerza Laboral en Salud , Recursos HumanosRESUMEN
Workforce planning ensures that the health workforce is aligned with current and future population needs. Engagement with partners and knowledge users is a leading practice in planning and is essential for planning to be successful. The goal of this study was to explore the considerations and processes involved in integrating engagement into workforce planning. Through a case study of primary care workforce planning in Toronto, we address the role of engagement, how it can be integrated into planning, and how lessons from engagement support spread and scale of effective workforce planning. In the course of engagement with five Ontario Health Teams between September 2023 and February 2024, we learned that there is considerable enthusiasm for planning, but that support is needed, and that engagement guides investment and strengthens relationships. We offer guidance for leaders with respect to actualizing engagement and building capacity for health workforce planning across the health system.
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Planificación en Salud , Fuerza Laboral en Salud , Ontario , Humanos , Liderazgo , Atención Primaria de Salud/organización & administración , Creación de Capacidad , Estudios de Casos OrganizacionalesRESUMEN
There is a critical shortage of health professionals globally which is affecting the possibility of attaining universal health coverage. Developing countries in sub-Saharan Africa such as Ghana and Nigeria are disproportionately affected and the shortfall in health professionals is envisaged to worsen over the next decade. Countries have responded differently in addressing this shortage. To understand the differing response to the same policy issue in two countries that share similar characteristics in terms of geolocation, socioeconomic indices and disease burden, this paper offers a comparative policy analysis of the two countries using the 3-I framework and punctuated equilibrium theory as comparative policy analysis tools. The analysis identified the ideas, interests, and institutions at play and how they have led to different policy outcomes in both countries. The analysis also shows the interaction between subsystems, policy images and policy venues and how this interaction led to policy change, in the case of Ghana and lag in the case of Nigeria. Our findings show four critical areas in addressing health workforce shortages in both countries - a general approach to addressing the issue, welfare and remuneration, workforce autonomy and career progression, and financing for workforce improvement. For Ghana, there has been significant policy change including implementing strategies for increasing the production of health professionals and addressing remuneration and welfare issues. For Nigeria, there has been seems to be a lag in policy change. While the findings show that Ghana's approach has seemingly put them on a good path toward universal health coverage, applying any lessons should, however, be contextual, considering other country-level and health systems factors that are relevant to addressing health workforce shortages.