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European variation in health workforce planning: do we need best practices or situational solutions?

Batenburg, R. European variation in health workforce planning: do we need best practices or situational solutions?: , 2013. 23 p. Abstract. In: Abstractbook EHMA Annual Conference 2013 'What healthcare can we afford? Better, quicker, lower cost health services'. 26-28 juni 2013, Milaan.
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Context:The feasibility study report published by Matrix Insight in 2012, is probably the first empirical and systematic comparison of health workforce planning systems in all European countries. As such, the report provides important data and information to explore what differences and similarities between health workforce planning systems can be discovered among countries. This exploration is important to shed light on one of the most critical questions currently at stake: does health workforce planning actually work, and what type of planning fits what type of health care system best? Methods: The main method applied in this paper is a cross-national analysis based on country information published in the Matrix report, complemented with other relevant country characteristics. Two sets of country metrics are developed in order to measure (1) a set of indicators for a countries' success in health workforce optimization, and (2) a set of indicators that are expected to be determinants for this success. Propositions and hypotheses are deduced from macro sociological, economic and cultural perspectives. In particular, the highly cited view of Frenk et al. (2010) is elaborated for this purpose. Expected country differences and interrelations on the national level are explored using the country data sets constructed. Basically, it is investigated if variation in health workforce planning among countries can be ranked according to success and determinants; or if this variation has a value by itself - and hence health workforce planning is fundamentally situational and multi-dimensional. Results: Country variation in the success and determinants of health workforce planning systems appears hard to measure in a reliable and valid manner. Given these limitations, country characteristics as central training control and health market regulation, become clear as determinants for health workforce planning. But at the same time these characteristics can be understood as situational factors that cannot be generalized among all European countries. Clustering countries along several dimensions seems the best way to foster the search for solutions that fit countries' health workforce system, tradition and circumstances. By all means, best practices in health workforce currently remain at a distance, as ‘evidence' is too limited and case-based. Discussion: Many lessons can be learned from the stream of data and information that is currently becoming available at the national and regional level within Europe with regard to health workforce planning. The quest for the best practice and success factors endangers the utilization of country-specific initiatives and the deductive power of country-specific experiences. Still, this study also demonstrates that analysing relationships and clusters at the country level feed new perspectives as well. This implies that a European approach to the ‘looming crises' in health workforce capacity can be achieved by a mutual understanding of patterns and diversity within and between health care systems.