Cargando…

Time trends in the regional distribution of physicians, nurses and midwives in Europe

BACKGROUND: Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribu...

Descripción completa

Detalles Bibliográficos
Autores principales: Winkelmann, Juliane, Muench, Ulrike, Maier, Claudia B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549210/
https://www.ncbi.nlm.nih.gov/pubmed/33046077
http://dx.doi.org/10.1186/s12913-020-05760-y
_version_ 1783592758107176960
author Winkelmann, Juliane
Muench, Ulrike
Maier, Claudia B.
author_facet Winkelmann, Juliane
Muench, Ulrike
Maier, Claudia B.
author_sort Winkelmann, Juliane
collection PubMed
description BACKGROUND: Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions in Europe and examine time trends. METHODS: We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005–2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 14 European Union (EU) countries and Switzerland being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR). RESULTS: There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria national average: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variations and varied up to 5.5-fold for physicians and 4.4-fold for nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tended to be higher in more sparsely populated areas. Over time, physician rates increased faster than density levels of nurses and midwives. CONCLUSIONS: The study shows for the first time the large variation in health workforce supply at regional levels and time trends by professions across the European region. This highlights the importance for countries to routinely collect data in sub-national geographic areas to develop integrated health workforce policies for health professionals at regional levels.
format Online
Article
Text
id pubmed-7549210
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-75492102020-10-13 Time trends in the regional distribution of physicians, nurses and midwives in Europe Winkelmann, Juliane Muench, Ulrike Maier, Claudia B. BMC Health Serv Res Research Article BACKGROUND: Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions in Europe and examine time trends. METHODS: We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005–2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 14 European Union (EU) countries and Switzerland being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR). RESULTS: There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria national average: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variations and varied up to 5.5-fold for physicians and 4.4-fold for nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tended to be higher in more sparsely populated areas. Over time, physician rates increased faster than density levels of nurses and midwives. CONCLUSIONS: The study shows for the first time the large variation in health workforce supply at regional levels and time trends by professions across the European region. This highlights the importance for countries to routinely collect data in sub-national geographic areas to develop integrated health workforce policies for health professionals at regional levels. BioMed Central 2020-10-12 /pmc/articles/PMC7549210/ /pubmed/33046077 http://dx.doi.org/10.1186/s12913-020-05760-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Winkelmann, Juliane
Muench, Ulrike
Maier, Claudia B.
Time trends in the regional distribution of physicians, nurses and midwives in Europe
title Time trends in the regional distribution of physicians, nurses and midwives in Europe
title_full Time trends in the regional distribution of physicians, nurses and midwives in Europe
title_fullStr Time trends in the regional distribution of physicians, nurses and midwives in Europe
title_full_unstemmed Time trends in the regional distribution of physicians, nurses and midwives in Europe
title_short Time trends in the regional distribution of physicians, nurses and midwives in Europe
title_sort time trends in the regional distribution of physicians, nurses and midwives in europe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549210/
https://www.ncbi.nlm.nih.gov/pubmed/33046077
http://dx.doi.org/10.1186/s12913-020-05760-y
work_keys_str_mv AT winkelmannjuliane timetrendsintheregionaldistributionofphysiciansnursesandmidwivesineurope
AT muenchulrike timetrendsintheregionaldistributionofphysiciansnursesandmidwivesineurope
AT maierclaudiab timetrendsintheregionaldistributionofphysiciansnursesandmidwivesineurope