Distribution Of Health Care Professionals Research Articles

Assessing The Relationship Between Demand And Accessibility For Pediatric Ophthalmology Services By State In The United States.

To investigate the relationship between public demand for pediatric ophthalmology services and the accessibility of such services on a statewide basis in the United States, focusing on strabismus care. Using Google Trends data, search volumes for "strabismus" were analyzed from January 2014 to December 2023. Pediatric ophthalmologist availability was assessed via the American Academy of Ophthalmology directory, normalized for state population size to create a relative demand index. Additional metrics from the United States Census Bureau and Centers for Disease Control and Prevention provided socioeconomic and health data. Correlation coefficients were used to explore relationships between search volumes, specialist availability, vision screening, socioeconomics, and demographic factors. The data revealed variability in public interest in pediatric ophthalmology across states, with Alaska showing the highest relative search volume for strabismus. The data also indicated notable disparities in pediatric ophthalmologist density, with North Dakota, Vermont, and Wyoming having no pediatric ophthalmologists. A significant correlation was identified between pediatric ophthalmologist availability and vision screening (R = 0.486, p < 0.001). Negative correlations were observed between the relative demand index and urbanization (R = -0.388, p = 0.007), as well as the strabismus prevalence (R = -0.455, p = 0.001), indicating that urbanization and specialist distribution influence eyecare demand and access. The findings highlight disparities in accessibility and demand for pediatric ophthalmology services across the US, influenced by urbanization and distribution of healthcare professionals. The study underscores the need for targeted interventions to improve access to care and bridge gaps in pediatric ophthalmology service provision.

Spatial Disparities in Access to Healthcare Professionals in Sichuan: Evidence from County-Level Data.

As a southwestern province of China, Sichuan is confronted with geographical disparities in access to healthcare professionals because of its complex terrain, uneven population distribution and huge economic gaps between regions. With 10-year data, this study aims to explore the county-level spatial disparities in access to different types of healthcare professionals (licensed doctors, registered nurses, pharmacists, technologists and interns) in Sichuan using temporal and spatial analysis methods. The time-series results showed that the quantity of all types of healthcare professionals increased, especially the registered nurses, while huge spatial disparities exist in the distribution of healthcare professionals in Sichuan. The local Moran’s I calculations showed that high–high clusters (significantly high healthcare professional quantity in a group of counties) were detected in Chengdu (capital of Sichuan) and relatively rich areas, while low–low clusters (significantly low healthcare professional quantity in a group of counties) were usually found near the mountain areas, namely, Tsinling Mountains and Hengduan Mountains. The findings may deserve considerations in making region-oriented policies in educating and attracting more healthcare professionals to the disadvantaged areas.

Social factors tend to decline age-standardized all-cause mortality rates in China during 2005–2015: evidence from an ecological study

ObjectivesIt is important to understand the factors that can substantially decrease mortality rates, as multiple strategies have been implemented to improve economic development and national health in China. We aimed to describe the geographic variations and changes in the all-cause mortality rates in 2005–2015 and to investigate the social factors that tend to decline age-standardized all-cause mortality rates. Study designEcological study. MethodsThe data used came from China’s National Census Survey in 2005, 2010 and 2015 and China National Statistical Yearbooks. We conducted provincial-level thematic mapping of age-standardized all-cause mortality rate trajectory groups in 2005–2015 by using ArcGIS. Generalized estimating equation (GEE) models were used to clarify the social factors that may have long-term relevance to declining age-standardized all-cause mortality rates. We compared the characteristics of the three provinces with the lowest mortality rates and the three provinces with the highest mortality rates to further understand the health disparities. ResultsThe age-standardized mortality rates declined from 2000 to 2006 and from 2008 to 2019. Provinces in the low-trajectory tended to be located in the Northeast and Southeast China. The GEE results revealed that the greater the proportion of the population with senior high school education or above, the more families with flushing or pumping toilets that are not shared with other households, the more nurses per 1000 people and a stable economic growth rate were inclined to low age-standardized all-cause mortality rates (P < 0.05). ConclusionsHealth disparities between different regions were still in existence even in 2015. Thus, it is critical to improve equality in economic and educational development, the distribution of healthcare professionals, and sanitation facilities, to ensure the equality of opportunities in terms of healthy lives and well-being for all. Furthermore, for developing countries, the improvement of national health urgently needs to prevent the health risks relevant to rapid industrialization and urbanization.

Data element mapping to analyze fit for use of three XML standards for health workforce tracking

BackgroundEnsuring a sufficient supply and distribution of health care professionals is essential to meeting public health needs. Regulatory agencies protect their communities by ensuring that new health professionals have the required qualifications to practice safely and by tracking the volume and distribution of those professionals on an ongoing basis. The speed and accuracy of sharing these data could be greatly improved through the adoption of a data standard for information about health professionals. To date, however, no internationally accepted standard has emerged for this purpose.PurposeThis study examines three existing XML standards designed for the representation of individual worker data to determine if, and to what degree, each could be used for the tracking of health professionals.MethodsThe data elements of the Europass schema, the HR Open Standard Recruiting specification, and the MedBiquitous Healthcare Professional Profile standard were fully examined and matching elements were mapped to the 200+ elements identified from a prior content analysis as required by a sample of 20 international regulatory agencies.ResultsNone of the schemas examined addressed more than half of the information elements required by regulators. All three schemas are found lacking in some key areas of interest, especially vital information that could disqualify ineligible applicant practitioners.ConclusionsThe three standards could all be improved by including new elements essential to regulatory agencies. Regulatory agencies should be consulted in the development of new standards for representing potentially disqualifying information about candidates for professional practice.

Positive Effects of Declining Age-Standardized All-Cause Mortality Rates in China During 2005-2015

Background: It is important to understand which factors can substantially decrease mortality rates, as multiple strategies have been implemented to improve economic development and national health in China. We aimed to describe the geographic variations and changes in the all-cause mortality rates in 2005-2015, and to investigate the positive effects of declining age-standardized all-cause mortality rates. Methods: The data used came from China’s National Census Survey in 2005, 2010 and 2015 and China National Statistical Yearbooks. We conducted provincial-level thematic mapping of age-standardized all-cause mortality rate trajectory groups in 2005-2015 by using ArcGIS. Generalized estimating equation (GEE) models were used to clarify the possible long-term effects of declining age-standardized all-cause mortality rates. We compared the characteristics of the three provinces with the lowest mortality rates and the three provinces with the highest mortality rates to further understand the associated health disparities. Results: The age-standardized mortality rates declined from 2000 to 2006 and from 2008 to 2019. Provinces in the low-trajectory tended to be located in the Northeast and Southeast China. The GEE results revealed that the greater the proportion of the population with senior high school education or above, the more families with flushing or pumping toilets that are not shared with other households, the more nurses per 1000 people and a stable economic growth rate can substantially decrease age-standardized all-cause mortality rates (p < 0·05). Interpretation: Regional disparities in population health still exist. Thus, it is critical to improve equality in economic and educational development, the distribution of healthcare professionals, and sanitation facilities, as well as people’s policy literacy, to ensure the equality of opportunities in terms of healthy lives and well-being for all. Furthermore, for developing countries, the improvement of national health urgently needs to prevent the health risks caused by rapid industrialization and urbanization. Funding: Natural Science Foundation of Fujian Province of China (No. 2018J01129). Conflict of Interest: We declare no competing interests.

Inequality trends in the demographic and geographic distribution of health care professionals in China: Data from 2002 to 2016

China has long been negatively affected by a shortage and maldistribution of health workers. This study aimed to examine the national and regional trends in the demographic and geographic distribution inequality of health care professionals in China from 2002 to 2016. Based on data from the China Health and Family Planning Statistical and China Statistical Yearbooks, we calculated the Gini coefficient and the Theil T and Theil L indices based on the number of health care professionals per capita and per geographic area to measure the inequalities in their demographic and geographic distribution, respectively. The contributions by intra-regional and inter-regional differences on total inequality were explored within and among East, Central, and West China via Theil index decomposition. We found that the national demographic distribution of health care professionals maintained in an absolute equality level, and the inequality indices decreased gradually, whereas the corresponding geographic inequalities were severe and presented a worsening trend. Compared with nurses, physicians not only maintained higher densities but also maintained a more equal distribution. Intra-regional disparities within the east, central, and western regions were the main cause for overall demographic inequality, whereas both intra-regional and inter-regional disparities significantly contributed to overall geographic inequality. To conclude, the distribution equality of health care professionals by population was satisfactory, whereas the corresponding distribution inequality by area was severe. Different types of distribution inequality of health care professionals existed regionally and nationally despite their increasing quantities and densities. Factors beyond population size should be considered when the government introduces health workforce allocation policies.

Patient aggression towards different professional groups of healthcare workers.

Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals' exposure to patient aggression in various countries. The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure. The study was performed between January 2008 - December 2009 in northeastern Poland, and included 1,624 healthcare workers (493 nurses, 504 midwives, 501 physicians and 126 medical rescue workers). Exposure to eight forms of patient aggression was assessed using the MDM Mobbing Questionnaire. Using a raised voice was the most frequently observed form of aggression in all groups, whereas the least frequent form of aggression encountered was the use of direct physical violence. In inpatient healthcare units, the intensity of patient aggression was encountered most by nurses and medical rescue workers, followed by physicians and midwives. In outpatient healthcare units, medical rescue workers experienced significantly higher levels of aggression when compared to other professional groups. Significant differences in mean aggression intensity experienced in inpatient and outpatient healthcare units were observed only in nurses and physicians. Furthermore, no significant effects of gender were observed on the intensity of patient aggression. Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

Shared decision-making in the People's Republic of China: current status and future directions.

BackgroundSevere insufficiencies in the supply and inequities in the distribution of health care professionals, facilities, and services create conditions for limited quality of care and lack of trust – even violent conflict – between clinicians and patients in the People’s Republic of China. Alongside structural reform, shared decision-making (SDM) may help meet the needs and advance the goals of each patient. Little is known, however, about the realities and opportunities for SDM in the People’s Republic of China.MethodsTo identify reports of SDM in the People’s Republic of China, we used multiple sources, including: several databases, searched in English and Chinese, online journals, and clinical trial registries. In addition, we contacted experts in the field to identify any articles missed through our other search strategies. We included all trials and surveys reporting on SDM in Chinese patients. We summarized these studies by describing them with particular attention to reports of patient decisional preference and of the impact of SDM interventions on outcomes in Chinese patients.ResultsWe identified five surveys examining patient preference for SDM and nine studies examining constructs related to SDM in Chinese patients, but none involving patients in Mainland China. We could not find any reports of development, testing, or implementation of SDM tools for patients in Mainland China.ConclusionThe research on SDM in the People’s Republic of China is limited, with almost no direct evidence to inform clinical policies or implementation. Although multiple barriers are apparent, the value of implementing, testing, and disseminating effective SDM in the People’s Republic of China in terms of patient experience and outcomes demands urgent realization.

Challenges of Clinical Leadership in Nigeria

Nigeria like the rest of the world is facing a universal health work force 'crunch' that is epitomized by widespread shortages of medical practitioners in positions of authority and consultation, this variance have led to inadequate distribution of healthcare professionals between and within healthcare institutions with poor working conditions and paucity of information and knowledge on best practice due to poor management of the health sector by politicians instead of medical professionals who take care of patients and who holds the best interest of the patients they care for (Conference of African Ministers of Health, 2005). Trending in Nigeria is the conventional view that medical practitioners should look after patients, while administrators look after organizations. Yet several pioneering healthcare institutions have turned this assumption on its head and achieved outstanding performance in the UK and in central Europe. This can be replicated in Nigeria through the adoption of clinical leadership practices and the restructuring of the healthcare system in Nigeria, which has been characterized by strike actions from medical practioners.Clinical leadership still, has a long road to travel in its expansion in healthcare management. To achieve the best and most sustainable quality of care, however, a commitment to building high-performing organizations must complement traditional values. All the evidence suggests that patients will see the benefit.

Distribución geográfica de los médicos en España y su evolución temporal durante el período 1998-2007

Population accessibility to health care depends on the geographical distribution of health care professionals. The aim of this study is to analyse the provincial distribution of Spanish physicians, its recent evolution and the factors related with it. Observational, cross-sectional, ecological, descriptive and analytical study on data from public official data sources (Statistics National Institute, Health and Consume Ministry). We obtained, on a provincial basis, variables related with physicians' distribution, socioeconomic conditions, health care resources and medical training capacity. We built some variability indicators for physicians' distribution, and we analysed the bivariated and multivariated correlations between provincial physicians' rate and the other variables. The ratio between the upper and lower values of the population based physicians' provincial ratio is 2,109 (2,158 in 1998), the variation coefficient is 0,19 (0,185 in 1998), and the Gini index is 0,103 (0,097 in 1998). There is a strong correlation between physicians' distribution and the specialist training capacity of each province in bivariated (r=0,87) and multivariated analysis (where socioeconomic and health care structure indicators and postgraduate training capacity explain 83,3% of physicians' distribution variance). The variability of physicians' distribution in Spain has been almost steady in the last decade, and its level is similar to that in other European countries. The provincial training capacity seems to play a fundamental role in physicians' distribution.

GEOGRAPHICAL PERSPECTIVES ON SAFE MOTHERHOOD IN THE HILL COUNTRY OF SRI LANKA: A CASE STUDY OF THE DORAGALA TEA PLANTATION IN PUSSELLAWA

ABSTRACT In comparison with other South Asian countries, Sri Lanka maintains well-developed health care systems. Nonetheless, limited health care services are provided to mothers and children in the hill country. This research raises a series of questions concerning current challenges for safe motherhood, such as health care services already present, spatial distribution of health care professionals, and health policy in the hill counties of Sri Lanka. The authors argue that to understand the existing infrastructure of health care systems and future challenges to provision of health care services, it is important to depict the spatial location of health care units and to recognize the complexity of interactions between these units and the social, economic, and health environment. Such assessment provides a human geography approach that investigates health care systems in spatial dimensions. This study uses the geographical techniques of Geographic Information Systems and Global Positioning Systems to answer the fundamental questions of “what is where,” “why is it there,” and “why do we care.” The questions underline the importance of spatial methodology in assessment of safe motherhood and the importance of accurate and precise knowledge about the status of maternal health.

The Nigeria health sector and human resource challenges

The Nigeria's health system is in a poor state and this is traceable to several factors especially the gross under-funding of the health sector and shortage of skilled medical personnel at the primary health care level. Nigeria is one of the several major health-staff-exporting countries in Africa. As a result of inadequate infrastructure and poor compensation packages, a sizeable number of physicians, nurses and other medical professionals are lured away to developed countries in search of fulfilling and lucrative positions. Related to brain drain is the problem of geographical distribution of health care professionals. There is a disproportionate concentration of medical professionals in urban areas. Health workers in under served areas usually have motivational problems at work which may be reflected in a variety of circumstances, but common manifestations include: lack of courtesy to patients; failure to turn up at work on time and high levels of absenteeism; poor process quality such as failure to conduct proper patient examinations and; failure to treat patients in a timely manner. These challenges can be addressed by increased funding of the health sector and the introduction of multiple incentives to health workers to make working in unattractive areas more appealing.

Health Work Force Planning in the 90s, Part II: Enough in the Right Place at the Right Time?

The focus of this discussion has been on achieving a distribution of health care professionals that meets the objective of making health services available to the total population. The need for a systematic approach to planning, not only for the health care work force, but for the system in general, has been recognized as the highest priority for the health care systems of industrialized countries for over a decade. Overall, the goal of health care work force planning the world over is "to provide the right type of education and training for the right number and type of people needed to render effectively and safely the right types of service when and where required by the population." What is needed is a readiness to evaluate existing service delivery models, to retain those found to be effective and efficient, and to re-direct resources from outdated or ineffective strategies into new approaches found to better meet this goal. We need to envision the health care work force as a whole; work toward making it as efficient as possible, and thereby maintain our national commitment to universal health care.