Objective: An effective response to a pandemic influenza assumes an adequate supply of a variety of skilled healthcare workers (HCWs). But what is known of HCWs’ willingness to report to work? Method: We identified 206 relevant studies from 9 healthcare databases. Of 28 heterogeneous studies that met inclusion criteria, 18 used common methods for calculating percentages of HCWs willing to report to work. Their findings were evaluated in greater depth. Results: In 28 studies that summarized willingness to report to work of 31,633 workers, the percentage of HCWs willing to report to work varied between 23.10% and 93.10%. Scale type and dichotomization of self-report scales led to significantly different results. In 4 studies where 2097 workers responded to a survey during an actual event (2009 H1N1 pandemic influenza) percentage willing to report to work varied from 23.1% to 90.1%. In 6 studies with hypothetical scenarios of avian influenza 50%–82.50% of HCWs were willing to report to work. Conclusion: The studies we reviewed have methodological problems and inconsistencies in findings, even within relatively homogenous study subgroups. We caution emergency planners from relying on findings from any single study that estimates HCWs’ mean willingness to report to work in a pandemic influenza outbreak.
The objective of the study was to examine available evidence on healthcare providers' willingness to report to work during a pandemic influenza and on related measures. Limited to scholarly journals, a search in nine databases produced 206 studies, 28 of which met inclusion criteria and were discussed in depth this review. Six studies posed an avian influenza scenario, four studies were conducted during the 2009/2010 global H1N1 pandemic influenza and the remaining 18 studies examined willingness to report to work under a scenario that was related to a pandemic influenza but the type of flu was under-specified. Willingness to report to work varied dramatically among the 28 studies, from a low of 23.1% to a high of 93.1%. Heterogeneous methods employed by researchers make it hard to generalize and draw practical conclusions. Preliminary evidence suggests that physicians may be more willing to report to work than nurses. Given the current state of the literature and the need to estimate workforce availability for preparedness planning, worst case scenario planners may cautiously assume that 1 in 4 healthcare providers will be willing to report to work during a pandemic influenza, not accounting for those who are ill. Because physicians demonstrated higher willingness, the 1 in 4 estimate could be adjusted upward for this provider group.
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