Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.537
Filtrar
2.
Lancet Oncol ; 22(2): 182-189, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33485458

RESUMO

BACKGROUND: The growing demand for cancer surgery has placed a global strain on health systems. In-depth analyses of the global demand for cancer surgery and optimal workforce requirements are needed to plan service provision. We estimated the global demand for cancer surgery and the requirements for an optimal surgical and anaesthesia workforce, using benchmarks based on clinical guidelines. METHODS: Using models of benchmark surgical use based on clinical guidelines, we estimated the proportion of cancer cases with an indication for surgery across 183 countries, stratified by income group. These proportions were multiplied by age-adjusted national estimates of new cancer cases using GLOBOCAN 2018 data and then aggregated to obtain the estimated number of surgical procedures required globally. The numbers of cancer surgical procedures in 44 high-income countries were divided by the actual number of surgeons and anaesthetists in the respective countries to calculate cancer procedures per surgeon and anaesthetist ratios. Using the median (IQR) of these ratios as benchmarks, we developed a three-tiered optimal surgical and anaesthesia workforce matrix, and the predictions were extrapolated up to 2040. FINDINGS: Our model estimates that the number of cancer cases globally with an indication for surgery will increase by 5 million procedures (52%) between 2018 (9 065 000) and 2040 (13 821 000). The greatest relative increase in surgical demand will occur in 34 low-income countries, where we also observed the largest gaps in workforce requirements. To match the median benchmark for high-income countries, the surgical workforce in these countries would need to increase by almost four times and the anaesthesia workforce by nearly 5·5 times. The greatest increase in optimal workforce requirements from 2018 to 2040 will occur in low-income countries (from 28 000 surgeons to 58 000 surgeons; 107% increase), followed by lower-middle-income countries (from 166 000 surgeons to 277 000 surgeons; 67% increase). INTERPRETATION: The global demand for cancer surgery and the optimal workforce are predicted to increase over the next two decades and disproportionately affect low-income countries. These estimates provide an appropriate framework for planning the provision of surgical services for cancer worldwide. FUNDING: University of New South Wales Scientia Scholarship and UK Research and Innovation Global Challenges Research Fund.


Assuntos
Anestesia/tendências , Planos de Sistemas de Saúde/tendências , Mão de Obra em Saúde/tendências , Neoplasias/cirurgia , Anestesia/economia , Atenção à Saúde/economia , Atenção à Saúde/tendências , Saúde Global/economia , Planos de Sistemas de Saúde/economia , Mão de Obra em Saúde/economia , Humanos , Renda , Neoplasias/economia , Neoplasias/epidemiologia , Cirurgiões/economia
3.
JAAPA ; 34(1): 1-8, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33332839

RESUMO

BACKGROUND: Physician assistants (PAs) and NPs have expanded roles in nephrology as both the patient load and acuity of care needed for this population have increased. PURPOSE: To evaluate the workforce patterns of PAs and NPs working in nephrology over the past decade. METHODS: Using the biannual survey from the National Kidney Foundation Council of Advanced Practitioners, data were collected and analyzed over the past decade. RESULTS: Surveys of nephrology practitioners show the evolution of the dialysis-focused practitioner to one encompassing all aspects of nephrology: hospital, ICU, research, office, and all types of dialysis. Salaries and benefits have increased to compensate for the expansion of responsibilities. CONCLUSIONS: PAs and NPs in nephrology have the opportunity to use their skills and training in caring for this high-risk population.


Assuntos
Nefrologia/tendências , Profissionais de Enfermagem/tendências , Assistentes Médicos/tendências , Papel Profissional , Competência Clínica , Diálise , Mão de Obra em Saúde/tendências , Humanos , Crescimento Demográfico , Fatores de Risco
4.
PLoS One ; 15(10): e0241331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095834

RESUMO

BACKGROUND: In the early phase of the Covid-19 pandemic, mainly data related to the burden of care required by infected patients were reported. The aim of this study was to illustrate the timeline of actions taken and to measure and analyze their impact on surgical patients. METHOD: This is a retrospective review of actions to limit Covid-19 spread and their impact on surgical activity in a Swiss tertiary referral center. Data on patient care, human resources and hospital logistics were collected. Impact on surgical activity was measured by comparing 6-week periods before and after the first measures were taken. RESULTS: After the first Swiss Covid-19 case appeared on February 25, progressively restrictive measures were taken over a period of 23 days. Covid-19 positive inpatients increased from 5 to 131, and ICU patients from 2 to 31, between days 10 and 30, respectively, without ever overloading resources. A 43% decrease of elective visceral surgical procedures was observed after Covid-19 (295 vs 165, p<0.01), while the urgent operations (all specialties) decreased by 39% (1476 vs 897, p<0.01). Fifty-two and 38 major oncological surgeries were performed, respectively, representing a 27% decrease (p = 0.316). Outpatient consultations dropped by 59%, from 728 to 296 (p<0.01). CONCLUSION: While allowing for maximal care of Covid-19 patients during the pandemic, the shift of resources limited the access to elective surgical care, with less impact on cancer care.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/tendências , Neoplasias/cirurgia , Pneumonia Viral/epidemiologia , Oncologia Cirúrgica/tendências , Assistência Ambulatorial/tendências , Infecções por Coronavirus/virologia , Alocação de Recursos para a Atenção à Saúde , Mão de Obra em Saúde/tendências , Hospitalização/tendências , Humanos , Unidades de Terapia Intensiva , Pandemias , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Encaminhamento e Consulta/tendências , Estudos Retrospectivos , Suíça/epidemiologia , Centros de Atenção Terciária
8.
Acad Med ; 95(10): 1499-1506, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32590470

RESUMO

The gender composition of physician specialties varies dramatically with some becoming increasingly female predominant while others remain overwhelmingly male. In their analysis of physician workforce data, the authors demonstrate that despite large increases in the number of female physicians over 4 decades, the degree of gender segregation between specialties has not declined. The authors describe lessons from the highly gender-segregated U.S. workforce as a whole to understand these demographic patterns in the physician workforce. Echoing U.S. workforce findings, women physicians are becoming overrepresented in certain specialties, and this appears to be associated with a relative decline in earnings for physicians in these specialties over time. The authors found a strong negative relationship between the proportion of female physicians in a specialty and its mean salary, with gender composition explaining 64% of the variation in salaries among the medical specialties.Female physicians face biases in the workplace and fall behind male peers in leadership attainment, academic advancement, and earnings. Tenacious gender stereotypes and the conflation of gender and status contribute to these biases and reinforce occupational gender segregation. The clustering of women in certain specialties means these specialties will be disproportionately affected by gender bias. Recognizing the consequences of gender demographics within physician specialties is important to maintain the strong and diverse physician workforce needed to support the health care needs of the populations who depend on these specialties for care.


Assuntos
Mão de Obra em Saúde/tendências , Medicina/tendências , Médicas/tendências , Sexismo/tendências , Feminino , Humanos , Liderança , Masculino , Estados Unidos
9.
Am J Ophthalmol ; 218: 128-135, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32445703

RESUMO

PURPOSE: To describe temporal and geographic trends in the US eye care workforce. DESIGN: Cross-sectional study. METHODS: We obtained data from the 2017 Area Health Resources File. The main outcomes were ophthalmologist and optometrist density, as defined as the number of providers per 100,000 individuals, the ratio of ophthalmologists ≥55 years of age to those <55 years of age, and county characteristics associated with the availability of an ophthalmologist. RESULTS: From 1995 to 2017, the national ophthalmologist density decreased from 6.30 to 5.68 ophthalmologists per 100,000 individuals. Although rural counties experienced a mean annual increase in ophthalmologist density by 2.26%, they still had a lower mean ophthalmologist density (0.58/100,000 individuals) compared with nonmetropolitan (2.19/100,000 individuals) and metropolitan counties (6.29/100,000 individuals) in 2017. The ratio of older to younger ophthalmologists increased from 0.37 in 1995 to 0.82 in 2017, with the greatest ratio increase occurring in rural counties (0.29 to 1.90). The presence of an ophthalmologist was significantly associated with a greater proportion of individuals with a college degree and health insurance, and more developed health care infrastructure. From 1990 to 2017, the density of optometrists increased from 11.06 to 16.16 optometrists per 100,000 individuals. CONCLUSIONS: Over the last 2 decades, the national density of ophthalmologists has decreased and the workforce has aged. In contrast, the density of optometrists has increased. Rural counties continue to have a disproportionately lower supply of eye care providers, although some growth has occurred. Given the rising ratio of optometrists to ophthalmologists, it is of interest for future work to determine how the optometrist workforce can best complement potential shortages of ophthalmologists.


Assuntos
Mão de Obra em Saúde/estatística & dados numéricos , Oftalmologistas/tendências , Optometristas/tendências , Adulto , Distribuição por Idade , Idoso , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Mão de Obra em Saúde/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmologistas/estatística & dados numéricos , Optometristas/estatística & dados numéricos , Médicas/estatística & dados numéricos , Médicas/tendências , População Rural/estatística & dados numéricos , Distribuição por Sexo , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos
10.
Ann Vasc Surg ; 66: 282-288, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32027989

RESUMO

BACKGROUND: Concern regarding the adequacy of the vascular surgery workforce persists. We aimed to predict future vascular surgery workforce size and capacity using contemporary data on the US population and number, productivity, and practice patterns of vascular surgeons. METHODS: The workforce size needed to maintain current levels of access was estimated to be 1.4 vascular surgeons/100,000 population. Updated population estimates were obtained from the US Census Bureau. We calculated future vascular surgery workforce needs based on the estimated population for every 10 years from 2020 to 2050. American Medical Association Physician Masterfile data from 1997 to 2017 were used to establish the existing vascular surgery workforce size and predict future workforce size, accounting for annual rates of new certificates (increased to an average of 133/year since 2013), retirement (17%/year), and the effects of burnout, reduced work hours, transitions to nonclinical jobs, or early retirement. Based on Medical Group Management Association data that estimate median vascular surgeon productivity to be 8,481 work relative value units (wRVUs)/year, excess/deficits in wRVU capacity were calculated based on the number of anticipated practicing vascular surgeons. RESULTS: Our model predicts declining shortages of vascular surgeons through 2040, with workforce size meeting demand by 2050. In 2030, each surgeon would need to increase yearly wRVU production by 22%, and in 2040 by 8%, to accommodate the workload volume. CONCLUSIONS: Our model predicts a shortage of vascular surgeons in the coming decades, with workforce size meeting demand by 2050. Congruence between workforce and demand for services in 2050 may be related to increases in the number of trainees from integrated residencies combined with decreases in population estimates. Until then, vascular surgeons will be required to work harder to accommodate the workload. Burnout, changing practice patterns, geographic maldistribution, and expansion of health care coverage and utilization may adversely affect the ability of the future workforce to accommodate population needs.


Assuntos
Necessidades e Demandas de Serviços de Saúde/tendências , Mão de Obra em Saúde/tendências , Determinação de Necessidades de Cuidados de Saúde/tendências , Cirurgiões/provisão & distribuição , Cirurgiões/tendências , Procedimentos Cirúrgicos Vasculares/tendências , Censos , Previsões , Humanos , Modelos Teóricos , Fatores de Tempo , Estados Unidos , Carga de Trabalho
12.
J Pediatr Ophthalmol Strabismus ; 57(1): 9-11, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31972034

RESUMO

The fate of pediatric ophthalmology may be in jeopardy. For the past 20 years, there has been declining interest in the field compared to other subspecialties in ophthalmology, as fellowship positions and jobs remain unfilled. Of those fellows who do match in pediatric ophthalmology and strabismus, many are international medical graduates who often return to their native countries to practice, further diminishing the supply of pediatric ophthalmologists in the United States. In previous surveys, resident graduates have expressed disinterest in the field, reluctance to work with children, inadequate reimbursements, and insufficient interactions with faculty as reasons not to pursue this subspecialty. Millions of people throughout the United States do not have access to pediatric ophthalmologists, highlighting the issue of unequal distribution. As more pediatric ophthalmologists retire, there is concern that there will not be enough providers to meet the demands of this subspecialty. Although many of these factors deterring residents from entering this field have been resolved, the major issue of financial reimbursements has not been adequately addressed. [J Pediatr Ophthalmol Strabismus. 2020;57(1):9-11.].


Assuntos
Necessidades e Demandas de Serviços de Saúde/tendências , Mão de Obra em Saúde/tendências , Oftalmologia/tendências , Pediatria/tendências , Escolha da Profissão , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Oftalmologia/economia , Pediatria/economia , Especialização/tendências
13.
N Z Med J ; 132(1507): 70-76, 2019 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-31830019

RESUMO

AIM: To characterise the demographics, size and distribution of the New Zealand rheumatology workforce. METHOD: An online survey was sent to New Zealand rheumatologists in February 2018. RESULTS: The survey was completed by 63 of 64 practising New Zealand rheumatologists (response rate 98%). In public practice, the number of half-day clinics per FTE was five (R2 linear 0.87), so a half-day session in private practice was counted as 0.2 FTE. There were 28.71 FTE in the public sector, 14.97 in private and 43.68 total FTE. By district health board (DHB), public FTE per capita ranged from 0.20 FTE per 100,000 population in Nelson-Marlborough DHB to 0.96 in Whanganui DHB. None of the 20 DHBs met the Royal College of Physicians guideline of 1.16 FTE per 100,000 population in the public sector, and only four DHBs reached this level when private FTE were included. Rheumatologists under the age of 50 years were predominantly female (62% female), and older rheumatologists predominantly male (7.7% female, p<0.001). In the next five years 6.58 FTE public rheumatologists intended to retire, (94% male). 23/53 (43%) of public hospital rheumatologists offer appointments for non-inflammatory conditions, compared to 30/31 (97%) of private practice rheumatologists. Between 1999 and 2011, the FTE per 100,000 population increased by 35.4%, but the rate of improvement slowed in the interval between 2011 and 2018, increasing by 3.0%. CONCLUSION: The New Zealand rheumatologist workforce is becoming more gender-balanced but is below recommended FTE levels, is unevenly distributed, and previously documented improvements in overall FTE have now reached a plateau.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Mão de Obra em Saúde/tendências , Reumatologistas/provisão & distribuição , Reumatologia , Adulto , Distribuição por Idade , Idoso , Feminino , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Setor Público/estatística & dados numéricos , Distribuição por Sexo , Inquéritos e Questionários
14.
BMJ Open ; 9(12): e032585, 2019 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-31826894

RESUMO

OBJECTIVES: Fractional (part-time) appointments are becoming more commonplace in many professions, including medicine. With respect to the contemporary oncological landscape, this highlights a critical moment in the optimisation of employment conditions to enable high-quality service provision given growing patient numbers and treatment volume intensification. Data are drawn from a broader study which aimed to better understand the workforce experiences of medical oncologists in Australia. This paper specifically aims to examine a group of clinicians' views on the consequences of fractional work in oncology. DESIGN: Qualitative, one-on-one semistructured interviews. Interview transcripts were digitally audio recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory. SETTING: New South Wales, Australia. PARTICIPANTS: Medical oncologists (n=22), including 9 female and 13 male participants, at a range of career stages. RESULTS: Four key themes were derived from the analysis: (1) increasing fractional employment relative to opportunities for full-time positions and uncertainty about future opportunities; (2) tightening in role diversity, including reducing time available for research, mentoring, professional development and administration; (3) emerging flexibility of medical oncology as a specialty and (4) impact of fractional-as-norm on workforce sustainability and quality of care. CONCLUSION: Fractional appointments are viewed as increasing in oncology and the broader consequences of this major shift in medical labour remain unexamined. Such appointments offer potential for flexible work to better suit the needs of contemporary oncologists; however, fractional work also presents challenges for personal and professional identity and vocational engagement. Fractional appointments are viewed as having a range of consequences related to job satisfaction, burnout and service delivery. Further research is needed to provide a critical examination of the multiple impacts of workforce trends within and beyond oncology.


Assuntos
Agendamento de Consultas , Atitude do Pessoal de Saúde , Mão de Obra em Saúde , Oncologia , Oncologistas , Austrália , Esgotamento Profissional/prevenção & controle , Atenção à Saúde/métodos , Feminino , Mão de Obra em Saúde/organização & administração , Mão de Obra em Saúde/tendências , Humanos , Satisfação no Emprego , Masculino , Oncologia/organização & administração , Oncologia/tendências , Oncologistas/psicologia , Oncologistas/estatística & dados numéricos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
15.
Blood Adv ; 3(22): 3550-3561, 2019 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-31738829

RESUMO

The current demand for adult hematologists in the United States is projected to exceed the existing supply. However, no national study has systematically evaluated factors affecting the adult hematology workforce. In collaboration with the American Society of Hematology (ASH), we performed a mixed methods study consisting of surveys from the annual ASH In-Service Exam for adult hematology/oncology fellows from 2010 to 2016 (8789 participants); interviews with graduating or recently graduated adult hematology/oncology fellows in a single training program (8 participants); and 3 separate focus groups for hematology/oncology fellowship program directors (12 participants), fellows (12 participants), and clinicians (10 participants) at the 2016 ASH annual meeting. In surveys, the majority of fellows favored careers combining hematology and oncology, with more fellows identifying oncology, rather than hematology, as their primary focus. In interviews with advanced-year fellows, mentorship emerged as the single most important career determinant, with mentorship opportunities arising serendipitously, and oncology faculty perceived as having greater availability for mentorship than hematology faculty. In focus group discussions, hematology, particularly benign hematology, was viewed as having poorer income potential, research funding, job availability, and job security than oncology. Focus group participants invariably agreed that the demand for clinical care in hematology, particularly benign hematology, exceeded the current workforce supply. Single-subspecialty fellowship training in hematology and the creation of new clinical care models were offered as potential solutions to these workforce problems. As a next step, ASH is conducting a national, longitudinal study of the adult hematology workforce to improve recruitment and retention in the field.


Assuntos
Mão de Obra em Saúde/tendências , Hematologia , Adulto , Escolha da Profissão , Educação de Pós-Graduação em Medicina , Análise Fatorial , Bolsas de Estudo , Feminino , Grupos Focais , Hematologia/educação , Humanos , Masculino , Oncologia/educação , Estados Unidos/epidemiologia
16.
N Z Med J ; 132(1506): 52-59, 2019 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-31778372

RESUMO

AIMS: To determine the career decision intentions of graduating doctors, and the relationship between these intentions and the predicted medical workforce needs in New Zealand in 10 years' time. METHODS: A workforce forecasting model developed by the Ministry of Health (MOH) has been used to predict the proportion of doctors required in each medical specialty in 2028 in New Zealand. The future work intentions of recently graduated doctors at the Universities of Auckland and Otago were collected from the Medical Student Outcomes Data (MSOD), and compared with these predicted needs. RESULTS: Between 2013 and 2017, 2,292 doctors graduated in New Zealand, of whom 1,583 completed the MSOD preferences section (response rate 69%). Of these only 50.1% had decided on a future medical specialty. The most popular were surgical specialties (26.2%), general practice (20.7%), and internal medicine (11.0%). Compared to the MOH workforce forecast model there appears to be insufficient interest in general practice at the time of graduation. CONCLUSIONS: To shape the medical workforce to meet forecast needs, multiple stakeholders will need to collaborate, with a special focus on the early postgraduate years, as many doctors have yet to decide on specialisation.


Assuntos
Emprego , Mão de Obra em Saúde/tendências , Médicos/provisão & distribuição , Estudantes de Medicina/estatística & dados numéricos , Adulto , Idoso , Escolha da Profissão , Bases de Dados Factuais , Feminino , Medicina Geral/estatística & dados numéricos , Humanos , Medicina Interna/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Motivação , Nova Zelândia , Especialidades Cirúrgicas/estatística & dados numéricos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Adulto Jovem
17.
Neurology ; 93(23): 1002-1008, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31690682

RESUMO

Neurology faces an increasing shortage of neurologists in the United States due to a growing demand for neurologic services. A 7% increase in the supply of neurologists is predicted from 2012 to 2025, whereas the demand will rise by 16%. An increase in the neurology workforce is critical to meet the demands, and a significant gender gap remains within the workforce that must be addressed to further ease the discrepancy between supply and demand. Individual, institutional, and societal factors contribute to this gender discrepancy and potentially result in the burnout or soft attrition of women from neurology. These factors, including earning disparity between male and female neurologists, one of the largest gaps in pay for any medical specialty, and the lack of representation at higher academic levels with only 12% (14 of 113) of neurology department chairs at academic medical centers being women, could lead to increased attrition of women from neurology. Identifying and mitigating these factors may help narrow the gender gap and increase the supply of neurologists to better meet future demand.


Assuntos
Esgotamento Profissional , Mão de Obra em Saúde , Neurologistas/provisão & distribuição , Neurologia , Distribuição por Sexo , Feminino , Mão de Obra em Saúde/estatística & dados numéricos , Mão de Obra em Saúde/tendências , Humanos , Masculino , Neurologistas/psicologia
19.
BJS Open ; 3(5): 704-712, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31592089

RESUMO

Background: A workforce crisis exists in global surgery. One solution is task-shifting, the delegation of surgical tasks to non-physician clinicians or associate clinicians (ACs). Although several studies have shown that ACs have similar postoperative outcomes compared with physicians, little is known about their surgical training. This study aimed to characterize the surgical training and experience of ACs compared with medical officers (MOs) in Tanzania. Methods: All surgical care providers in Pwani Region, Tanzania, were surveyed. Participants reported demographic data, years of training, and procedures assisted and performed during training. They answered open-ended questions about training and post-training surgical experience. The median number of training cases for commonly performed procedures was compared by cadre using Wilcoxon rank sum and Student's t tests. The researchers performed modified content analysis of participants' answers to open-ended questions on training needs and experiences. Results: A total of 21 ACs and 12 MOs participated. ACs reported higher exposure than MOs to similar procedures before their first independent operation (median 40 versus 17 cases respectively; P = 0·031). There was no difference between ACs and MOs in total training surgical volume across common procedures (median 150 versus 171 cases; P = 0·995). Both groups reflected similarly upon their training. Each cadre relied on the other for support and teaching, but noted insufficient specialist supervision during training and independent practice. Conclusions: ACs report similar training and operative experience compared with their physician colleagues in Tanzania.


Assuntos
Cirurgia Geral/educação , Pessoal de Saúde/educação , Médicos/estatística & dados numéricos , Preceptoria/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/educação , Adulto , Pessoal Técnico de Saúde/educação , Competência Clínica/estatística & dados numéricos , Educação Médica/métodos , Estudos de Avaliação como Assunto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Mão de Obra em Saúde/organização & administração , Mão de Obra em Saúde/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza/economia , Pobreza/estatística & dados numéricos , Preceptoria/métodos , Qualidade da Assistência à Saúde , Estudos Retrospectivos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Tanzânia/epidemiologia
20.
Hum Resour Health ; 17(1): 72, 2019 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623619

RESUMO

BACKGROUND: The feminisation of the global health workforce presents a unique challenge for human resource policy and health sector reform which requires an explicit gender focus. Relatively little is known about changes in the gender composition of the health workforce and its impact on drivers of global health workforce dynamics such as wage conditions. In this article, we use a gender analysis to explore if the feminisation of the global health workforce leads to a deterioration of wage conditions in health. METHODS: We performed an exploratory, time series analysis of gender disaggregated WageIndicator data. We explored global gender trends, wage gaps and wage conditions over time in selected health occupations. We analysed a sample of 25 countries over 9 years between 2006 and 2014, containing data from 970,894 individuals, with 79,633 participants working in health occupations (48,282 of which reported wage data). We reported by year, country income level and health occupation grouping. RESULTS: The health workforce is feminising, particularly in lower- and upper-middle-income countries. This was associated with a wage gap for women of 26 to 36% less than men, which increased over time. In lower- and upper-middle-income countries, an increasing proportion of women in the health workforce was associated with an increasing gender wage gap and decreasing wage conditions. The gender wage gap was pronounced in both clinical and allied health professions and over lower-middle-, upper-middle- and high-income countries, although the largest gender wage gaps were seen in allied healthcare occupations in lower-middle-income countries. CONCLUSION: These results, if a true reflection of the global health workforce, have significant implications for health policy and planning and highlight tensions between current, purely economic, framing of health workforce dynamics and the need for more extensive gender analysis. They also highlight the value of a more nuanced approach to health workforce planning that is gender sensitive, specific to countries' levels of development, and considers specific health occupations.


Assuntos
Ocupações em Saúde/economia , Ocupações em Saúde/tendências , Mão de Obra em Saúde/economia , Mão de Obra em Saúde/tendências , Salários e Benefícios/tendências , Mulheres , Feminino , Humanos , Análise de Séries Temporais Interrompida , Papel Profissional
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...