Abstract
BackgroundThe health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004.MethodsWith census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates.ResultsThe Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners), while after adjusting for consultation rates the number was 20.6% (315). These figures changed to 6.3% (100), 6.3% (115) and 19.8% (315) in 2004.ConclusionThere was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.
Highlights
The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern
As Albania has moved during the last decade towards a national health care system that emphasizes the development of primary care [1,2], there is a debate on how to ensure that quality of care is guaranteed to all Albanians [1,2,3]
Quality and equity have been considered together as the key concepts of the WHO strategy "Towards Unity for Health". Both concepts are closely linked with the health workforce, and especially with those serving in primary health care [5]
Summary
The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. For over 40 years Albania had a Stalinist economy, in which the means of production came under the principle of controlled planning and state ownership [1,2]. During this period, the health sector in Albania was not considered to be a productive element of economy and was (page number not for citation purposes). Quality and equity have been considered together as the key concepts of the WHO strategy "Towards Unity for Health" Both concepts are closely linked with the health workforce, and especially with those serving in primary health care [5]
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