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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 783-788, 2021 Sep.
Artículo en Chino | MEDLINE | ID: mdl-34622593

RESUMEN

Objective: To understand the basic public health service (BPHS) tasks and workload of the township hospitals in Sichuan Province and to provide empirical evidence for improving the allocation of human resources (HR) and the quality of BPHS in township hospitals. Methods: Retrospective survey was conducted to collect information regarding the actual working hours per unit time of service of BPHS. Information on the service volume and unit service time of BPHS tasks for 2018 was collected in 7 township hospitals in an economically developed area and an area of moderate economic development. Estimated HR required to cover the BPHS tasks was calculated based on the survey data of actual work time. Results: The time required for the basic units of various BPHS tasks varied greatly. The top four most time-consuming services showing consistent results in the the two regions were health education, health supervision and coordination, management of children aged 0-6 and maternal care management. Institutions in the area of moderate economic development reported higher per capita service volume in the registration of children for vaccination, management of hypertension, and health supervision and coordination than those in the economically developed area, but lower service volume for other services. There is a shortage of full-time staffs in both areas. Conclusion: Differences in the service volume of BPHS exist in regions of different levels of economic development. The shortage in HR could be related to the lower quality and volume of the service. Comprehensive exploration of policies to recruit and retain competent personnel, the strengthening of grassroots professional training, and optimization of information technology will help improve the competence and quality of grassroots services.


Asunto(s)
Hospitales , Salud Pública , Recursos Humanos , Carga de Trabajo , Niño , China , Humanos , Estudios Retrospectivos
2.
F1000Res ; 10: 87, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34631013

RESUMEN

Background: Multiple long-term care (LTC) reports have issued similar recommendations for improvement across Canadian LTC homes. Our primary objective was to identify the most common recommendations made over the past 10 years. Our secondary objective was to estimate the total cost of studying LTC issues repeatedly from 1998 to 2020. Methods: The qualitative and cost analyses were conducted in Canada from July to October 2020. Using a list of reports, inquiries and commissions from The Royal Society of Canada Working Group on Long-Term Care, we coded recurrent recommendations in LTC reports. We contacted the sponsoring organizations for a cost estimate, including direct and indirect costs. All costs were adjusted to 2020 Canadian dollar values. Results: Of the 80 Canadian LTC reports spanning the years of 1998 to 2020, 24 (30%) were based on a national level and 56 (70%) were focused on provinces or municipalities. Report length ranged from 4 to 1491 pages and the median number of contributors was 14 (interquartile range, IQR, 5-26) per report. The most common recommendation was to increase funding to LTC to improve staffing, direct care and capacity (67% of reports). A median of 8 (IQR 3.25-18) recommendations were made per report. The total cost for all 80 reports was estimated to be $23,626,442.78. Conclusions: Problems in Canadian LTC homes and their solutions have been known for decades. Despite this, governments and non-governmental agencies continue to produce more reports at a monetary and societal cost to Canadians.


Asunto(s)
Cuidados a Largo Plazo , Canadá , Costos y Análisis de Costo , Humanos , Recursos Humanos
3.
Health Res Policy Syst ; 19(Suppl 3): 107, 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34641893

RESUMEN

BACKGROUND: This is the fourth of our 11-paper supplement on "Community Health Workers at the Dawn of New Era". Here, we first make the case for investing in health programmes, second for investing in human resources for health, third for investing in primary healthcare (PHC) workers, and finally for investing in community health workers (CHWs). METHODS: Searches of peer-reviewed journals and the grey literature were conducted with a focus on community health programme financing. The literature search was supplemented with a search of the grey literature for information about national health sector plans, community health strategies/policies, and costing information from databases of various countries' ministries of health, and finally a request for information from in-country partners. RESULTS: The global shortage of human resources for health is projected to rise to 18 million health workers by 2030, with more acute shortages in Africa and South Asia. CHWs have an important role to play in mitigating this shortage because of their effectiveness (when properly trained and supported) and the feasibility of their deployment. Data are limited on the costs of current CHW programmes and how they compare to government and donor expenditures for PHC and for health services more broadly. However, available data from 10 countries in Africa indicate that the median per capita cost of CHW programmes is US$ 4.77 per year and US$ 2574 per CHW, and the median monthly salary of CHWs in these same countries is US$ 35 per month. For a subset of these countries for which spending for PHC is available, governments and donors spend 7.7 times more on PHC than on CHW programming, and 15.4 times more on all health expenditures. Even though donor funding for CHW programmes is a tiny portion of health-related donor support, most countries rely on donor support for financing their CHW programmes. CONCLUSION: The financing of national CHW programmes has been a critical element that has not received sufficient emphasis in the academic literature on CHW programmes. Increasing domestic government funding for CHW programmes is a priority. In order to ensure growth in funding for CHW programmes, it will be important to measure CHW programme expenditures and their relationship to expenditures for PHC and for all health-related expenditures.


Asunto(s)
Agentes Comunitarios de Salud , Atención Primaria de Salud , Política de Salud , Promoción de la Salud , Humanos , Recursos Humanos
4.
J Contin Educ Nurs ; 52(10): 452-453, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34609248

RESUMEN

As a result of the cornoavirus disease 2019 (COVID-19) pandemic, the health care industry is facing one of its worse workforce crises in decades. Nurse educators must influence the development and implementation of a strategic workforce plan to mitigate this crisis. [J Contin Educ Nurs. 2021;52(10):452-453.].


Asunto(s)
COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Recursos Humanos
5.
Nurs Womens Health ; 25(5): 329-336, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34602165

RESUMEN

OBJECTIVE: To solicit advice from members of the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) on what to include in an update of nurse staffing standards. DESIGN: Online, single-question survey with thematic analysis of responses. SETTING: Electronic survey link sent via e-mail. PARTICIPANTS: AWHONN members who shared their e-mail with the association and who responded to the survey (n = 1,813). MEASURES: Participants were asked to answer this single question: "The AWHONN (2010) Guidelines for Professional Registered Nurse Staffing for Perinatal Units are being updated. During their initial development, feedback from nearly 900 AWHONN members was extremely helpful in providing specific details for the nurse staffing guidelines. We'd really like to hear from you again. Please give the writing team your input. What should AWHONN consider when updating the AWHONN nurse staffing guidelines?" RESULTS: The e-mail was successfully delivered to 20,463 members; 8,050 opened the e-mail, and 3,050 opened the link to the survey. There were 1,892 responses. After removing duplicate and blank responses, 1,813 responses were available for analysis. They represented all hospital practice settings for maternity and newborn care and included nurses from small-volume and rural hospitals. Primary concerns of respondents centered on two aspects of patient acuity-the increasing complexity of clinical cases and the need to link nurse staffing standards to patient acuity. Other themes included maintaining current nurse-to-patient ratios, needing help with implementation in the context of economic challenges, and changing wording from "guidelines" to "standards" to promote widespread adoption. CONCLUSION: In a single-question survey, AWHONN members offered rich, detailed recommendations that were used in the updating of the AWHONN nurse staffing standards.


Asunto(s)
Guías como Asunto , Enfermeras y Enfermeros , Personal de Enfermería en Hospital/normas , Recursos Humanos/normas , Femenino , Humanos , Recién Nacido , Enfermería Neonatal , Relaciones Enfermero-Paciente , Parto , Admisión y Programación de Personal , Embarazo , Sociedades de Enfermería
6.
BMJ Open ; 11(10): e049134, 2021 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-34607860

RESUMEN

OBJECTIVE: Early in the COVID-19 pandemic, US Veterans Health Administration (VHA) employee occupational health (EOH) providers were tasked with assuming a central role in coordinating employee COVID-19 screening and clearance for duty, representing entirely novel EOH responsibilities. In a rapid qualitative needs assessment, we aimed to identify learnings from the field to support the vastly expanding role of EOH providers in a national healthcare system. METHODS: We employed rapid qualitative analysis of key informant interviews in a maximal variation sample on the parameters of job type, rural versus urban and provider gender. We interviewed 21 VHA EOH providers between July and December 2020. This sample represents 15 facilities from diverse regions of the USA (large, medium and small facilities in the Mid-Atlantic; medium sites in the South; large facilities in the West and Pacific Northwest). RESULTS: Five interdependent needs included: (1) infrastructure to support employee population management, including tools that facilitate infection control measures such as contact tracing (eg, employee-facing electronic health records and coordinated databases); (2) mechanisms for information sharing across settings (eg, VHA listserv), especially for changing policy and protocols; (3) sufficiently resourced staffing using detailing to align EOH needs with human resource capital; (4) connected and resourced local and national leaders; and (5) strategies to support healthcare worker mental health.Our identified facilitators for EOH assuming new challenging and dynamically changing roles during COVID-19 included: (A) training or access to expertise; (B) existing mechanisms for information sharing; (C) flexible and responsive staffing; and (D) leveraging other institutional expertise not previously affiliated with EOH (eg, chaplains to support bereavement). CONCLUSIONS: Our needs assessment highlights local and system level barriers and facilitators of EOH assuming expanded roles during COVID-19. Integrating changes both within and across systems and with alignment of human capital will enable EOH preparedness for future challenges.


Asunto(s)
COVID-19 , Salud Laboral , Personal de Salud , Humanos , Evaluación de Necesidades , Pandemias , SARS-CoV-2 , Salud de los Veteranos , Recursos Humanos
7.
BMC Health Serv Res ; 21(1): 1052, 2021 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-34610827

RESUMEN

BACKGROUND: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists' retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. METHODS: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. RESULTS: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. CONCLUSIONS: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours.


Asunto(s)
Farmacéuticos , Servicios de Salud Rural , Humanos , Motivación , Población Rural , Recursos Humanos
8.
Cien Saude Colet ; 26(suppl 2): 3435-3446, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-34468640

RESUMEN

The scope of this critical narrative review is the analysis of the national literature on the implementation of the More Doctors Program (PMM), from January 2016 to May 2019, distributed according to its three programmatic aspects: 1. Improvement of Infrastructure of the Primary Health Care Networks; 2. Expansion of Vacancies and Courses in Medicine and the Reform of Medical Education; and 3. Emergency Medical Supplies. After consulting the Scielo and Lilacs databases through the key words Programa Mais Médicos, and the English and Spanish equivalents, 37 articles were located, of which 31 were selected because they focused specifically on the implementation of one or more aspects. Aspect 1 had the lowest number of publications, while the highest concentration of articles occurred in aspects 2 and 3, in 2016 and 2019, respectively, depending on the timely implementation of the PMM. The literature analyzed points to successes and weaknesses in the formulation and implementation of the Program. This should be taken into consideration in the elaboration and execution of future projects, based on the expansion of access and the universalization of medical care to vulnerable populations.


Asunto(s)
Programas de Gobierno , Médicos , Brasil , Atención a la Salud , Instituciones de Salud , Humanos , Recursos Humanos
9.
J Addict Nurs ; 32(3): 197-204, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34473449

RESUMEN

ABSTRACT: This article provides examples of the application of technology transfer to improve the delivery of addiction prevention, treatment, and recovery. The article describes a case example of two regional Technology Transfer Centers (TTCs) focused on addiction and mental health. It illustrates the importance of cross-regional and network-wide activities as well as meaningful collaborations with other regional networks, professional associations, and state and federal entities. This article describes a model of identifying and delivering meaningful training and technical assistance (T/TA), which also advances interprofessional collaborations and shared ownership. The described model includes collaboration in assessing behavioral health T/TA needs and preference for delivery of T/TA. The case study presents the process of engaging providers and connecting them with content experts on emerging topics in the field of addiction. This work included T/TA around integrated care, co-occurring disorders, cultural humility and inclusion, and use of data to advance system care. The case also outlines the application and use of evidence-based translation models, including Project ECHO (Extension for Community Healthcare Outcomes) and Communities of Practice.


Asunto(s)
Fuerza Laboral en Salud , Psiquiatría , Humanos , Salud Mental , Transferencia de Tecnología , Recursos Humanos
10.
Artículo en Ruso | MEDLINE | ID: mdl-34486852

RESUMEN

The purpose of the study was to analyze normative legal documents and their modifications in order to determine the labor standards of medical personnel in case of rendering and planning obstetric gynecological care in the Russian Federation, including standards of number of medical personnel in medical organizations and modes of operation of various types. The materials of the study were normative legal documents presented at the WEB-portal "garant.ru". The comparative analysis of actual normative legal set of documents concerning labor standards in the profile of "obstetrics and gynecology" demonstrated that the new order of Minzdrav of Russia № 1130n of 20.10.2020 introduced significant changes as compared with the current one. Its provisions contribute to reducing staffing by obstetricians-gynecologists of medical organizations providing primary health care, and to decreasing significantly the number of nurses for all types of considered medical organizations. The main drawback of the new order and the erroneousness of the orders on Procedures of Minzdrav of Russia in terms of staff support of round-the-clock functioning are demonstrated. The methodology of calculating the number of positions under different modes of operation of medical organizations are presented. The dynamics of general population morbidity in classes "Pregnancy, childbirth and complications of the postpartum period" and "Diseases of the genitourinary system" was analyzed.The corresponding trends were prognosticated for the period up to 2024. The results of the study testify the necessity to amend actual normative legal documents governing labor standards of medical personnel in case of providing obstetric gynecological and other types of medical care in the Russian Federation.


Asunto(s)
Obstetricia , Femenino , Personal de Salud , Humanos , Embarazo , Atención Primaria de Salud , Federación de Rusia , Recursos Humanos
11.
Artículo en Ruso | MEDLINE | ID: mdl-34486860

RESUMEN

Currently, the characteristic of dynamics of morbidity of mental disorders of population of the Russian Federation is its increasing simultaneously with changing in structure of contingents in the direction of decreasing number of patients subjected to dispensary monitoring. The study of influence of medical organizational factors on morbidity of mental disorders demonstrated the role of provision with psychiatrists in dynamics of prevalence of mental disorders. The improvement of management of patients with mental disorders should be supported by appropriate resources and adaptation of mental service to actual conditions, in particular, solving the problem of manpower deficiency of psychiatrists.


Asunto(s)
Trastornos Mentales , Psiquiatría , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Morbilidad , Prevalencia , Recursos Humanos
12.
Artículo en Inglés | MEDLINE | ID: mdl-34501912

RESUMEN

The COVID-19 pandemic in Germany has demanded a substantially larger public health workforce to perform contact tracing and contact management of COVID-19 cases, in line with recommendations of the World Health Organization (WHO). In response, the Robert Koch Institute (RKI) established the national "Containment Scout Initiative" (CSI) to support the local health authorities with a short-term workforce solution. It is part of a range of measures for strengthening the public health system in order to limit the spread of SARS-CoV-2 in Germany. The CSI is an example of how solutions to address critical health system capacity issues can be implemented quickly. It also demonstrates that medical or health-related backgrounds may not be necessary to support health authorities with pandemic-specific tasks and fulfil accurate contact tracing. However, it is a short-term solution and cannot compensate for the lack of existing qualified staff as well as other deficits that exist within the public health sector in Germany. This article describes the structure and process of the first phase of this initiative in order to support health policymakers, public health practitioners, and researchers considering innovative and flexible approaches for addressing urgent workforce capacity issues.


Asunto(s)
COVID-19 , Pandemias , Trazado de Contacto , Alemania/epidemiología , Fuerza Laboral en Salud , Humanos , Salud Pública , SARS-CoV-2 , Recursos Humanos
13.
BMC Health Serv Res ; 21(1): 1027, 2021 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-34587959

RESUMEN

BACKGROUND: In India, the distribution and retention of biomedical doctors in public sector facilities in rural areas is an obstacle to improving access to health services. The Government of Uttar Pradesh is developing a comprehensive, ten-year Human Resources for Health (HRH) strategy, which includes policies to address rural distribution and retention of government doctors in Uttar Pradesh (UP). We undertook a stakeholder analysis to understand stakeholder positions on particular policies within the strategy, and to examine how stakeholder power and interests would shape the development and implementation of these proposed policies. This paper focuses on the results of the stakeholder analysis pertaining to rural distribution and retention of doctors in the government sector in UP. Our objectives are to 1) analyze stakeholder power in influencing the adoption of policies; 2) compare and analyze stakeholder positions on specific policies, including their perspectives on the conditions for successful policy adoption and implementation; and 3) explore the challenges with developing and implementing a coordinated, 'bundled' approach to strengthening rural distribution and retention of doctors. METHODS: We utilized three forms of data collection for this study - document review, in-depth interviews and focus group discussions. We conducted 17 interviews and three focus group discussions with key stakeholders between September and November 2019. RESULTS: We found that the adoption of a coordinated policy approach for rural retention and distribution of doctors is negatively impacted by governance challenges and fragmentation within and beyond the health sector. Respondents also noted that the opposition to certain policies by health worker associations created challenges for comprehensive policy development. Finally, respondents believed that even in the event of policy adoption, implementation remained severely hampered by several factors, including weak mechanisms of accountability and perceived corruption at local, district and state level. CONCLUSION: Building on the findings of this analysis, we propose several strategies for addressing the challenges in improving access to government doctors in rural areas of UP, including additional policies that address key concerns raised by stakeholders, and improved mechanisms for coordination, accountability and transparency.


Asunto(s)
Médicos , Servicios de Salud Rural , Humanos , India , Políticas , Recursos Humanos
14.
Praxis (Bern 1994) ; 110(13): 725-732, 2021 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-34583535

RESUMEN

This questionnaire-based cross-sectional analysis with 2037 Swiss general practitioners (GPs) focused on young GPs (≤40 years) and investigated which preconditions would allow them high satisfaction and low stress levels in their work. Young GPs (n = 206) are more often female (57 %, p <0.001), 46 % are employed, have a lower workload (38.2 vs. 44.0 hours per week, p <0.001) and plan significantly more often consultations of 30 minutes (p = 0.006) than older colleagues. Under 40-year-old GPs were more satisfied with their work situation (p = 0.046), but had a higher stress level (p = 0.01) compared to GPs >40 years of age. Administrative tasks tend to increase stress levels (p = 0.054). Knowing the problems of the young GP workforce is essential to securing the next generation of physicians.


Asunto(s)
Médicos Generales , Satisfacción en el Trabajo , Adulto , Estudios Transversales , Femenino , Humanos , Médicos de Familia , Encuestas y Cuestionarios , Suiza , Recursos Humanos , Carga de Trabajo
15.
J Nurs Adm ; 51(10): 488-494, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34519700

RESUMEN

OBJECTIVE: The aim of this study was to describe the relationships between perceptions of the pandemic impact on clinical nurses' and nurse leaders' intent to leave their current position and the profession and the differences in pandemic impact and intent to leave variables based on background factors. BACKGROUND: There is much discussion and concern about the COVID-19 pandemic impact on nurses' health and the nursing workforce. METHODS: More than 5000 nurses from a national sample participated in a cross-sectional, descriptive study. Participants rated their perceptions of the pandemic impact on their practice and their intent to leave their position and profession. RESULTS: Pandemic impact was rated high overall and was highest in nurses with 25+ years of experience and in managers/directors. Eleven percent of the total sample indicated they intended to leave their position, and 20% were undecided. Nurses who rated pandemic impact at the highest level had higher intent to leave their position. Of the respondents, less than 2% indicated they were leaving the nursing profession, whereas 8% were undecided. CONCLUSIONS: This is the 1st quantitative report of perceived level of pandemic impact on direct care nurses and nurse managers/directors at the time of this writing. The combination of those who intend to leave and those who are uncertain about leaving their positions could cause instability in the workforce if not reversed. Organizational attention to nurse well-being, work environment and staffing is imperative.


Asunto(s)
COVID-19/psicología , Intención , Enfermeras y Enfermeros/psicología , Reorganización del Personal , Recursos Humanos/estadística & datos numéricos , Lugar de Trabajo , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Autoinforme , Estados Unidos
16.
Health Aff (Millwood) ; 40(9): 1377-1385, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34495716

RESUMEN

Assisted living provides housing and long-term care services to more than 811,000 older adults in the United States daily and is regulated by the states. This article describes changes in the specificity of state regulations governing the staffing in assisted living settings (that is, requirements for sufficient staffing or staffing ratios or levels) between 2007 and 2018 and the association between these changes and rates of hospitalization among a national sample of assisted living residents, including a subgroup with dementia. We found that increased regulatory specificity for direct care workers (for example, a change from requiring "sufficient" direct care worker staffing to requiring a specific staffing ratio or level) was associated with a 4 percent reduction in the monthly risk for hospitalization among residents in our sample and a 6 percent reduction among the subgroup with dementia. However, an increase in regulatory specificity for licensed practical nurses was associated with a 2.5 percent increase in the monthly risk for hospitalization and a 5 percent increase among the subgroup with dementia. Given that no federal requirements exist for the number of staff members or composition of staff in assisted living, these findings can inform states' policy decisions about staffing requirements for assisted living settings.


Asunto(s)
Instituciones de Vida Asistida , Anciano , Atención a la Salud , Hospitalización , Humanos , Estados Unidos , Recursos Humanos
17.
Health Aff (Millwood) ; 40(9): 1368-1376, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34495726

RESUMEN

Different staffing configurations in primary and geriatric care practices could have implications for how best to deliver services that are essential for a growing population of older adults. Using data from a 2018 survey of physicians (MDs) and nurse practitioners (NPs) working in primary and geriatric care, we assessed whether different configurations were associated with better or worse performance on a number of standard process measures indicative of comprehensive, high-quality primary care. Practices with a large concentration of MDs had the highest estimated labor costs. Practices high in NPs and physician assistants (PAs) were most common in states that grant full scope of practice to NPs. The high-NP/PA configuration was associated with a 17-percentage-point greater probability of facilitating patient visits and a 26-percentage-point greater probability of providing the full bundle of primary care services compared with the high-MD model. Team-based configurations had a 27.7-percentage-point greater probability of providing the full bundle of primary care services. The complex needs of older adults may be best served by team-based practices with a broad provider mix that can provide a range of services in the office and the community.


Asunto(s)
Geriatría , Enfermeras Practicantes , Asistentes Médicos , Anciano , Anciano Frágil , Humanos , Atención Primaria de Salud , Estados Unidos , Recursos Humanos
18.
Can Vet J ; 62(9): 1000, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34475587
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