Analysis of the association between millennium development goals 4 &amp; 5 and the physician workforce across international economic strata

Morley, Christopher P.; Wang, Dongliang; Mader, Emily M.; Plante, Kyle; Kingston, Lindsey N.; Rabiei, Azadeh

doi:10.1186/s12914-017-0126-2

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…Longitudinal studies from the United States of America [ 20 ], Japan [ 21 ], Brazil [ 22 ], Vietnam [ 14 ], Mozambique [ 23 ], and Lesotho [ 24 ] reported that the density of health care workforce was negatively associated with the infant mortality rate (IMR) and under-five mortality rate (U5MR). This conclusion has also been reached in several cross-country studies with both longitudinal [ 17 , 25 , 26 ] and cross-sectional designs [ 11 , 12 , 18 , 27 ].…”

Section: Introductionsupporting

confidence: 60%

The impact of the health care workforce on under-five mortality in rural China

et al. 2019

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BackgroundPrevious studies have focused on the relationship between increases in the health care workforce and child health outcomes, but little is known about how this relationship differs in contexts where economic growth differs by initial level and pace. This study evaluates the association between increased health professionals and the under-five mortality rate (U5MR) in rural Chinese counties from 2008 to 2014 and examines whether this relationship differs among counties with different patterns of economic growth over this period.MethodsWe estimated fixed effects models with rural counties as the unit of analysis to evaluate the association between health professional density and U5MR. Covariates included county-level gross domestic product (GDP) per capita, female illiteracy rate, value of medical equipment per bed, and province-level health expenditures (measured as a proportion of provincial GDP). To explore modification effects, we assessed interactions between health professionals and county types defined by county poverty status and county-level trajectories of growth in GDP per capita. U5MR data have been adjusted for county-level underreporting, and all other data were obtained from administrative and official sources.ResultsThe U5MR dropped by 36.19% during the study period. One additional health professional per 1000 population was associated with a 2.6% reduction in U5MR, after controlling for other covariates. County poverty status and GDP trajectories moderated this relationship: the U5MR reductions attributed to a one-unit increase in health professionals were 6.8% among poor counties, but only 1.1% among non-poor ones. These reductions were, respectively, 6.7%, 0.7%, and 4.3% in counties with initially low GDP that slowly increased, medium-level GDP that rose at a moderate pace, and high GDP that rose rapidly.ConclusionsThis study demonstrates that increased health professionals were associated with reductions in U5MR. The largest association was seen in poor counties and those with low and slowly increasing GDP per capita, which justifies further expansion of the health care workforce in these areas. This study could be instructive for other developing countries to achieve Sustainable Development Goal 3 by helping them identify where additional health professionals would make the greatest contribution.Electronic supplementary materialThe online version of this article (10.1186/s12960-019-0357-5) contains supplementary material, which is available to authorized users.

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Section: Introductionsupporting

confidence: 60%

The impact of the health care workforce on under-five mortality in rural China

et al. 2019

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“…The loss of trained health personnel from areas where health systems are already stressed to their limits leave the remaining professionals overwhelmed and demoralized and can result in a critical lack of services [7,11,12,13,14,15]. An analysis published in 2017 found significant decreases in maternal, neonatal, and under-5 mortalities for every increase of one physician per 1000 population in 208 countries, supporting the importance of an adequate physician workforce [16]. The loss of physicians to migration is particularly expensive for governments and medical communities in LMICs because of the number of years and the cost it takes to train them, and this is the reason we chose to particularly focus on physician migration [17,18].…”

Section: Introductionmentioning

confidence: 99%

Global Brain Drain: How Can the Maslow Theory of Motivation Improve Our Understanding of Physician Migration?

Dohlman

DiMeglio

Hajj

et al. 2019

IJERPH

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The migration of physicians from low-resource to high-resource settings is a prevalent global phenomenon that is insufficiently understood. Most low-income countries are severely understaffed with physicians, and the emigration of the already limited number of physicians to other countries can significantly reduce access to healthcare in the source country. Despite a growing interest in global capacity building in these countries by academic and non-governmental organizations in high-income countries, efforts to stem physician migration have been mostly unsuccessful. The authors reviewed the current literature for the motivational factors leading to physician migration in the context of Maslow’s hierarchy of human needs. Our study found that financial safety needs were major drivers of physician emigration. However, factors related to self-actualization such as the desire for professional development through training opportunities and research, were also major contributors. These findings highlight the multifactorial nature of physician motivations to emigrate from low-resource countries. Maslow’s Theory of Motivation may provide a useful framework for future studies evaluating the concerns of physicians in low-income countries and as a guide to incentivize retention.

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“…However, their practice is often complicated by credentialing, licensing, and reimbursement barriers [ 5 , 10 ]. However, even after their increasing integrations and post-COVID-19 innovation acceleration in healthcare system, patients often have trouble in accessing services [ 11 – 13 ]. These shortages can be addressed by APP depending on the state and hospital regulations [ 6 , 8 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Kreeftenberg et al [ 1 ], Landsperge et al [ 9 ], Mileski et al [ 14 ] and Gershengorn et al [ 15 ] Primary reasons for any limitations include that the practice is often complicated by credentialing, licensing, and reimbursement barriers [ 16 ]. However, even if these barriers are reduced, the demand for healthcare service outstrips available healthcare delivery by various providers [ 11 , 13 ]. Therefore, another solution is needed to multiply the capacity of the existing workforce while continuing to deliver a high quality of care.…”

Section: Introductionmentioning

confidence: 99%

Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program

Laudański

Huffenberger²,

Scott

et al. 2022

BMC Health Serv Res

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Incorporating the advanced practice provider (APP) in the delivery of tele critical care medicine (teleCCM) addresses the critical care provider shortage. However, the current literature lacks details of potential workflows, deployment difficulties and implementation outcomes while suggesting that expanding teleCCM service may be difficult. Here, we demonstrate the implementation of a telemedicine APP (eAPP) pilot service within an existing teleCCM program with the objective of determining the feasibility and ease of deployment. The goal is to augment an existing tele-ICU system with a balanced APP service to assess the feasibility and potential impact on the ICU performance in several hospitals affiliated within a large academic center. A REDCap survey was used to assess eAPP workflows, expediency of interventions, duration of tasks, and types of assignments within different service locations. Between 02/01/2021 and 08/31/2021, 204 interventions (across 133 12-h shift) were recorded by eAPP (nroutine = 109 (53.4%); nurgent = 82 (40.2%); nemergent = 13 (6.4%). The average task duration was 10.9 ± 6.22 min, but there was a significant difference based on the expediency of the task (F [2; 202] = 3.89; p < 0.022) and type of tasks (F [7; 220] = 6.69; p < 0.001). Furthermore, the eAPP task type and expediency varied depending upon the unit engaged and timeframe since implementation. The eAPP interventions were effectively communicated with bedside staff with only 0.5% of suggestions rejected. Only in 2% cases did the eAPP report distress. In summary, the eAPP can be rapidly deployed in existing teleCCM settings, providing adaptable and valuable care that addresses the specific needs of different ICUs while simultaneously enhancing the delivery of ICU care. Further studies are needed to quantify the input more robustly.

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Analysis of the association between millennium development goals 4 & 5 and the physician workforce across international economic strata

Cited by 7 publications

References 16 publications

The impact of the health care workforce on under-five mortality in rural China

The impact of the health care workforce on under-five mortality in rural China

Global Brain Drain: How Can the Maslow Theory of Motivation Improve Our Understanding of Physician Migration?

Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program

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