Health Care Manpower Research Articles

A survey of the status quo of respiratory physicians teambuilding in China

Objective To probe into the total number and development status of respiratory physicians in China, and to analyze existing problems, for reference in making strategy and policy decisions in professional development of respiratory physicians in the country. Methods The basic information of China′s healthcare institutions and healthcare manpower in 2015 were provided by the Statistics Center of the National Health Commission.The number of respiratory specialists and their profile, drawn from such basic information, were subject to descriptive statistics. Results In 2015, there were 2.729 million medical practitioners(including assistant doctors)nationwide, 30.3 thousand among whom being respiratory physicians, accounting for 1.11% of the total.Among these respiratory physicians, practicing respiratory physicians account for 87.1%, respiratory physicians with a master degree and above account for only 19.7%, respiratory physicians with over 10 years of working experience account for 65.8%, respiratory physicians with senior titles account for only 21.4%, and 89.4% of the respiratory physicians work in general hospitals. Conclusions By the criteria of specializing in respiratory specialty over five years and being attending or above, the number approximates 14.6 thousand nationwide.If practicing(assistant)physicians specializing in respiratory specialty are also included, the number may hit 30.3 thousand. Such a number, compared with other specialties, may be sufficient, yet their competence is far from satisfactory.Therefore it is imperative to build a standardized pulmonary medicine fellowship training system for their competence improvement. Key words: Hospitals, specialty; Health manpower; Respiratory physicians; Number; Development

A Basic Study for Human Rights-friendly Healthcare Manpower Training : : The Relationship between Emotional Labor and Clinical Practice Stress among Nursing Students

A Basic Study for Human Rights-friendly Healthcare Manpower Training : : The Relationship between Emotional Labor and Clinical Practice Stress among Nursing Students

Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.

BackgroundMobile phone technology is utilized for better delivery of health services worldwide. In low-and-middle income countries mobile phones are now ubiquitous. Thus leveraging mHealth applications in health sector is becoming popular rapidly in these countries. To assess the effectiveness of the Continuum of Care Services (CCS) mHealth platform in terms of strengthening the delivery of maternal and child health (MCH) services in a district in Bihar, a resource-poor state in India.MethodsThe CommCare mHealth platform was customized to CCS as one of the innovations under a project funded by the Bill and Melinda Gates Foundation to improve the maternal and newborn health services in Bihar. The intervention was rolled out in one project district in Bihar, during July 2012. More than 550 frontline workers out of a total of 3000 including Accredited Social Health Activists, Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were trained to use the mHealth platform. The service delivery components namely early registration of pregnant women, three antenatal visits, tetanus toxoid immunization of the mother, iron and folic acid tablet supply, institutional delivery, postnatal home visits and early initiation of breastfeeding were used as indicators for good quality services. The resultant coverage of these services in the implementation area was compared with rest of Bihar and previous year statistics of the same area. The time lag between delivery of a service and its record capture in the maternal and child tracking system (MCTS) database was computed in a random sample of 16,000 beneficiaries. The coverage of services among marginalized and non-marginalized castes was compared to indicate equity of service delivery. Health system strengthening was viewed from the angle of coverage, quality, equity and efficiency of services.ResultsThe implementation blocks had higher coverage of all the eight indicator services compared to rest of Bihar and the previous year. There was equity of services across castes for all the indicators. Timely capture of data was also ensured compared to paper-based reporting.ConclusionBy virtue of its impact on quality, efficiency and equity of service delivery, health care manpower efficiency and governance, the mHealth inclusion at service provision level can be one of the potential strategy to strengthen the health system.

English

Provision of health care ser-vice is the second most important function of a medical college besides creation of the health care manpower. Quality, equity, relevance and cost-effectiveness are the four universally acknowledged characteristics of health care. In the present time medical colleges are facing the arduous task of demonstrating that they respond to health needs of the patients, families, communities and the nation at large. This calls for identification of community needs, adaptation of the Medical colleges’ programmes to meet them and provide evidence that the community has benefitted from these interventions.

The Promise of E-Platform Technology in Medical Education.

Increasing the number as well as improving the capacity and quality of medical professionals to achieve an equitable health care for all is a global priority and a global challenge. In developing countries, which are facing the largest burden of disease, to achieve the above stated objective, there is a big need for more well-trained, competent and dedicated health care providers. Currently, there is a well-documented shortage of trained health workers globally, with the poorest countries having the greatest shortfalls. The time tested, traditional approach of training health care force by importing professionals from overseas is not only prohibitively expensive but also not sufficient to achieve the scale and pace of the required human capacity building. Considering this fact, distance learning programs, which include m-Health as well as other information technology (IT) platforms and tools, can provide unique, timely, cost-effective, easily scalable and valuable opportunities to expand access to training health care manpower in developing countries where the shortage is critical.

A Literature Review on Quality of Working Life: A Case of Healthcare Workers

Objectives: The purpose of the study was to explore the characteristic of Quality of Working Life (QWL) research studies related to healthcare sector. Methods: We systematically searched PubMed, Science Direct, and Cochrane Library databases till February 2015. We uses those search term that are ‘health occupation’, ‘health personnel’, ‘medical staff’, ‘nurse health care manpower’, ‘health manpower’, ‘healthcare manpower’, ‘health professional’, ‘practitioner’, ‘quality of working life’, ‘quality of work life’, ‘QWL’ and ‘QoWL’. Results: A total of 56 articles researching QWL were identified, of which 16 papers met the inclusion criteria. In those papers, the first study of QWL was published in 1994. Asia, America, and Europe had published seven, six and four papers, respectively. The number of papers that focus on QWL of nurses (n=9, 52.9%) was the most concerned sector. There are over 200 participants (n=9, 52.9%) in the major studies. The factors that affect QWL are job satisfaction, homework interface, working conditions, compensation, human relations, management-personnel relations and support. Conclusion: Nowadays, there are nine countries that focus on QWL of healthcare staffs by researching and assessing concerned factors to enhance worker’s satisfaction and support workers to be better manager change and transition.

Improving capability of local public hospital and health center against newly emerging infectious diseases after Middle East respiratory syndrome epidemic in Korea

Healthcare system in Korea was found to be very vulnerable to public health emergency preparedness and response as demonstrated in the recent outbreak of Middle East Respiratory Syndrome Coronavirus. We need to redefine the function of and improve the capability of local district public hospital and local health center to cope with potential threats by newly emerging infectious disease in the nearer future. While central government may be responsible for early detection of newly emerging infectious disease transmitted from outside of the country, local government and its district-level public healthcare agencies need to primarily control over spread of the disease among the local residents. Governance setting for rapid response required in public health crisis situation appears to be possible based on strong local public health infrastructure for health promotion and disease prevention at si-gun-gu district level. Proper and sustainable investment is also needed for local public hospital with high standard facilities and skilled healthcare manpower since there seems little economic incentives to maintain such facilities in private hospitals. In conclusion, it would be urgent task to improve prevention activities for infectious disease of local health centers and clinical activities of local public hospital. Especially, role and competencies of public health physicians working at the public health center need to be specified as an essential component of public health infrastructure.

Modernizing and transforming medical education at the Kilimanjaro Christian Medical University College.

The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.

Sociodemographic Factors and Clerkship Experience Influence Ibadan Medical Students' Preference for Radiology Specialty

Over the years, there has been a significant rise in the number of graduates from medical schools in sub-Saharan Africa. A recent study of 105 selected medical schools found an increase from about 8,000 graduates in 2008 to >18,000 in 2011 [1]. Despite the large number of medical graduates produced, there are challenges in terms of the migration of these new doctors to developed nations, with an attendant shortfall in health care manpower. It is estimated that as many as a quarter of medical graduates migrate out of their home countries within 5 years of graduation [2].

Too few doctors or too low wages? Labor supply of health care professionals in China

This paper estimates the labor supply functions for health care professionals in China using Census-based data in 2005. The rapid economic growth and population aging in China led to a substantial increase in the demand for health care services and the derived demand for health care professionals in recent years. However, the increase in the supply of doctors and nurses lags behind the growth in demand, raising the question of whether the excess demand should be met by expanding the health care manpower or by inducing the existing personnel to work more hours through wage increase. Our findings indicate that wage rate adjustment has a significant impact on the length of working time among the self-employed practitioners (with an estimated short-run elasticity of 0.575), while the labor supply of hospital employees is inelastic due to their fixed payment scheme. Instead, hours worked in the employee group are related to non-wage factors such as asset holdings and the hospital ownership type. An important policy implication of our study is that adjustments of labor compensation methods and hospital ownership structure are potentially effective approaches for coping with the excess demand for health care professionals and improving the quality of health care in China.

Comparative study of healthcare staffing between China and other countries

A comparison of healthcare staffing between China and typical countries discovered the following: Generally low staffing capacity of healthcare manpower in China; irrational structuring of specialists, especially doctor-nurse ratio; irrational layout of human resources among institutions; speed of human resources education no less than developed countries. In view of these facts and line with health reform needs, the following are proposed: Develop a new plan for healthcare manpower; reinforcing nursing education; reinforcing education of grass-root healthcare personnel; integration of medical education planning with talent demands. Key words: Healthcare manpower; Staffing; China-foreign comparison

Psychiatry in UG curriculum of medicine: Need of the hour

Byline: M. Thirunavukarasu Planning for health is a relatively new activity in most developing countries. Planning for mental health is an even more recent activity. In 1975, WHO released its first report on mental-health service planning in developing countries. If you really follow it up, little action has been taken; and if any action has been taken, it has been very patchy. Certain heads of state believe that mental illness is not at all present in their country and it is a problem of the West. Not all politicians and health administrators subscribe to these views, but until recently many of them had rather narrow and negative views about mental-health care. In most people's minds mental illnesses are equated with madness, and the popular belief is that such patients should be locked up in hospitals. Few realize and acknowledge most common mental-health problems are dependence on tobacco and alcohol, depression, anxiety, childhood problems, sexual dysfunction, sleeping and eating disorders rather than psychoses, which are the most conspicuous illnesses. Take the rate of suicide and attempted suicide and its prevalence; this clearly indicates high prevalence of underlying depression and its inadequate treatment. Lakhs of people, mostly young, have died because of suicide. Furthermore, a large number of persons have been displaced and exposed to political, religious and other conflict situations over the past few decades. Take the disaster like tsunami, which necessitated hunting for mental-health workers or service personnel. Psychiatric epidemiology in India - Moving beyond numbers is the topic of a chapter in the recently released book Mental health - An Indian perspective. India with its population of more that one billion faces myriad health problems. The increase in per capita income, along with changing health-care availability, with control of nutritional and infectious disorders, has resulted in greater life expectancy of people. The scenario has also brought to the fore the new challenge of behavior-linked manmade lifestyle-related problems. In this evolving health-care scenario, noncommunicable diseases pose major problems due to lack of skilled health-care manpower, inadequate information and inability of the system to meet this challenge all over the world, including India. The aggressive, market-oriented liberalizing economy in combination with an invasive media has helped in rapid expansion of hazardous life styles. The social, biological and psychological strengths of the past have been slowly replaced by a fragile life pattern of people, making them more vulnerable to social, mental and psychological problems at all ages. Mental-health problems have long been recognized in every society. Communities had their own mechanisms of handling these problems, many of which are gradually being replaced by modern science. A greater understanding of mind and behavior in all dimensions has revolutionized our efforts of managing problems in today's society. The interaction of man's mind and behavior is at an exciting phase today, with advances in genetic, molecular, biochemical and environmental domains based on agent-host environment approach. The organization of service for those with mental-health problems has moved from crude primitive methods to more sophisticated technological approaches with a combination of pharmacological and nonpharmacological methods. The Indian medical education system is one of the largest in the world and consists of 262 medical schools, each associated with a university producing 28,000 doctors each year. One-third of these doctors leave India every year for residency and/or practice abroad, with around 1,500 medical graduates immigrating to the USA each year to enter residency training. The quality of Indian medical education and the physicians it produces therefore has implications for the USA and the entire world. A number of high-profile issues confront undergraduate education in India, a country with a long history of medicine. …

SARS: How to Manage Future Outbreaks?

Severe acute respiratory syndrome (SARS) was an unknown disease barely 3 years ago. After the World Health Organization declared the world SARS-free on 5 July 2003, there were episodic recurrences of SARS between September 2003 and May 2004, including 4 cases of laboratory-acquired SARS. SARS posed a mammoth challenge because of the impact of nosocomial transmission on healthcare manpower and facilities, and the resources needed for controlling and preventing further spread. Through worldwide scientific collaboration, the medical community has made much progress in unraveling its enigma, though much more needs to be discovered. This paper highlights how we can apply our knowledge of its epidemiology, mode of transmission, clinical course, ICU admission, complications, predictors of poor outcome, treatment and infection control to help us avert a catastrophic outbreak, and to manage our resources and patients. SARS preparedness and response planning must be flexible and dynamic so that appropriate measures can be implemented as an outbreak progresses. Even if SARS does not reemerge, the experience gained from such planning is valuable in preparing for threats of bioterrorism or a global avian influenza A (H5N1) virus pandemic.

Nurses can be good substitutes.

The Government is determined to deliver the expectations of the electorate regarding improved access to effective first-point-of-contact health care. Rising expectations together with doctor shortages are forcing the reshaping of healthcare manpower, and previous ‘sacred cows’ of the roles of professional groups are being challenged. Against this background, nurses are increasingly delivering aspects of care management previously within the domain of doctors. At the heart of this lies the extension of prescribing rights.

Who deserves publicly funded nursing care?

The current nurse staffing crisis is highlighting the contribution of nurses as part of healthcare manpower, and nursing care to the wellbeing of patients. While those with long-term disabilities and chronic illness living in the community have become accustomed to a lack of skilled nursing in their care, it is now apparent that acute healthcare services are also feeling the pinch. In the current climate it will be easy for those with ongoing needs to be forgotten as politicians seek rapid solutions to lengthening waiting lists and media reports of cancelled life-saving surgery.

Gender Comparisons Prior to, during, and after Medical School Using Two Decades of Longitudinal Data at Jefferson Medical College

Similarities and differences prior to, during, and after medical school between 3,541 men and 1,121 woman graduates of Jefferson Medical College were investigated. Gender comparisons were made on examination scores, admissions interview ratings, competence ratings in residency, specialty choice, board certification, income estimates, and academic appointments. Results indicated that prior to medical school, women scored higher on verbal tests, whereas men outscored women on quantitative and science tests. During medical school, men performed better than women in the basic science examinations, but not in the clinical science examinations. Men and women had similar postgraduate competence ratings except that women were rated higher than men in the socioeconomic aspects of patient care. Women had lower board certification rates, expected less income, and had a higher proportion offaculty appointments than did men. Gender differences in specialty choices, faculty appointments, and estimated income could have important implications for health care manpower

A population-based study of the association of medical manpower with county trauma death rates in the United States.

To determine the association between measures of medical manpower available to treat trauma patients and county trauma death rates in the United States. The primary hypothesis was that greater availability of medical manpower to treat trauma injury would be associated with lower trauma death rates. When viewed from the standpoint of the number of productive years of life lost, trauma has a greater effect on health care and lost productivity in the United States than any disease. Allocation of health care manpower to treat injuries seems logical, but studies have not been done to determine its efficacy. The effect of medical manpower and hospital resource allocation on the outcome of injury in the United States has not been fully explored or adequately evaluated. Data on trauma deaths in the United States were obtained from the National Center for Health Statistics. Data on the number of surgeons and emergency medicine physicians were obtained from the American Hospital Association and the American Medical Association. Data on physicians who have participated in the American College of Surgeons (ACS) Advanced Trauma Life Support Course (ATLS) were obtained from the ACS. Membership information for the American Association for Surgery of Trauma (AAST) was obtained from that organization. Demographic data were obtained from the United States Census Bureau. Multivariate stepwise linear regression and cluster analysis were used to model the county trauma death rates in the United States. The Statistical Analysis System (Cary, NC) for statistical analysis was used. Bivariate and multivariate analyses showed that a variety of medical manpower measures and demographic factors were associated with county trauma death rates in the United States. As in other studies, measures of low population density and high levels of poverty were found to be strongly associated with increased trauma death rates. After accounting for these variables, using multivariate analysis and cluster analysis, an increase in the following medical manpower measures were associated with decreased county trauma death rates: number of board-certified general surgeons, number of board-certified emergency medicine physicians, number of AAST members, and number of ATLS-trained physicians. This study confirms previous work that showed a strong relation among measures of poverty, rural setting, and increased county trauma death rates. It also found that counties with more board-certified surgeons per capita and with more surgeons with an increased interest (AAST membership) or increased training (ATLS) in trauma care have lower per-capita trauma death rates.(ABSTRACT TRUNCATED AT 400 WORDS)

Contributions of the Surgical Sciences to a Reduction of the Mortality Rate in the United States for the Period 1968 to 1988

The authors sought to determine whether advances in the surgical sciences have led to a reduction in mortality rates for diseases treated by surgery during the past 25 years. They also wished to study changes in health care manpower for perioperative care during this period. Surgical operations requiring general anesthesia in the United States have risen to 25 million per year at an annual cost of approximately $125 billion. During the period 1968 to 1988, the number of anesthesiologists per 100,000 persons in the United States increased 98%, although the number of surgeons remained relatively constant. Between 1980 and 1989, the number of radiologists per 100,000 persons decreased to 29% below the figure for 1965. Membership in specialized nursing societies increased dramatically. The authors used vital statistics data from the National Center for Health Statistics (NCHS) to examine the mortality rates for diseases of the prostate, appendix, and gallbladder; hernia and intestinal obstruction; and ulcerative disease of the stomach and duodenum for the years 1968, 1978, and 1988. NCHS hospital discharge data were used to derive the rates of hospitalization and surgery for these conditions. Information on changes in health care manpower was obtained from published and other sources. The mortality rates for the five diseases studied decreased from 40% to 69% between 1968 and 1978. Between 1978 and 1988, the mortality rates caused by benign prostatic hyperplasia declined an additional 54% and by appendicitis, an additional 43%. Deaths attributable to the other conditions remained relatively constant. The rates of hospitalization and surgery for these conditions varied. Advances in surgery, anesthesiology, and information transfer and the availability of intensive care units and specialized hospital personnel have resulted in reduced mortality rates for diseases treated by surgery.

Education as Part of the Health Care Solution

THESE are extremely turbulent times for health care, the health professions, and the educational institutions that prepare professionals for service to the public. Most discussion regarding reform tends to focus on the health care provision and financing systems, ignoring two key components of change: health care manpower and the education of providers. The public resources that have built educational institutions and the health care system over the past four decades are now severely limited. How will medical schools and teaching hospitals begin the task of developing new educational responses to the nation's health care needs? What will drive the change needed in the schools and hospitals to ensure that our future physicians and care providers can support and practice in a changed system? Over the past 8 years, the Pew Charitable Trusts have focused on achieving within schools the structural changes that empower them to respond more effectively to the

A multifactorial study of birth place options: improving health care delivery in Saudi Arabia

Although consumer demands may dictate a review of the highly mechanized and sophisticated technology of obstetric care provided in some parts of the western world, problems in Saudi Arabia revolve around under-utilization of health care facilities for maternity care and the consequences of this circumstance. A multifactorial analysis was performed to study the association of certain social correlates with options for birth settings in a rural region of the Kingdom. Age and educational level of the mother were found to be highly significant (P < 0.005) variables influencing the choice for place of delivery, whereas economic status (P > 0.1) and housing conditions (NS) tailed to make an equally impressive contribution. Within the constraints of available health care manpower at the local level, suggestions are made for the best strategy to successfully educate mothers for safer options in birth.