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Cross-national comparison of human resources for health in the Netherlands and Portugal.

Martins-Coelho, G., Batenburg, R. Cross-national comparison of human resources for health in the Netherlands and Portugal. Abstract. In: Book of Abstracts of the European Health Management Association Annual Conference 2010 'Managing Radical Change in Health. Quality, Efficiency, Equity', 30 juni- 2 juli 2010, Lahti, Finland. 10-11
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CONTEXT: Manpower is critical for health care systems. It is, however, one of the least strategically planned resources, resulting in mismatches on the health care labour market. There are several approaches available for health manpower planning. Yet little is known about which (if any) is applied by EU countries, and what their success is. Identifying, describing and comparing these approaches provides insights into: (1) how health manpower planning is actually applied; (2) how it can be used by health care systems to improve labour market efficiency; and (3) how new challenges, such as global migration of health workers can be addressed. METHODS: The objective of this paper is to compare two different European countries, the Netherlands and Portugal. To investigate their health manpower planning, we describe: (1) the health workforce characteristics and trends of both countries, (2) their health manpower planning approaches, and (3) the specific variables that can be explanatory for the differences between the two countries. In our country comparative analysis, we focus on differences in organisation and funding of the health care system in relation to the actual health manpower planning approach. We retrieved data from international registries and national health authorities websites, and interviewed key informants in both countries. Based on these sources, the tradition and approach to health manpower planning is described, as well as the specific manpower planning method. To explain the differences between manpower planning in the Netherlands and Portugal, seven types of determinants were assessed: political, organisational, economic, social, cultural, technical and educational. RESULTS: The Portuguese Government created a task force in 1998 to prepare a health manpower planning study, among other attributions. That study was published in 2001 and discussed the supply of physicians, nurses and allied health personnel, and made projections for 2021. EU averages were used as a benchmark for future health manpower development. The task force had its mandate extended in 2003, but manpower planning was removed from its responsibilities. In the Netherlands, a ‘Capacity Body' was created in 1999 to annually monitor the demand and supply of health care manpower and project the required numbers of doctors and nurses to be trained for the next 10 to 15 years. This model captures parameters for manpower supply and demand, aiming at an equilibrium of the Dutch labour market. While the Netherlands engage in more detailed health manpower planning than Portugal, both countries equally struggle in achieving optimal human resources planning for health. ANALYSIS: This study has provided insight into manpower planning approaches in two European countries. The comparison shows that the relationship between manpower planning and labour market stability is a complex one. In a sense, the Netherlands tend to extensively plan their health care workforce, whereas Portugal tends to apply a more reactive approach. For both countries, planning will remain an important tool to cope with changes in size, composition and behaviour of the workforce. Specifically, the challenge is to improve productivity to respond to the increasing health care demand and need for cost-containment. We will expand the study at the EU level. This will allow us to elaborate a chart of health manpower planning approaches adopted by each EU country, and factors that explain cross-national variation. It will provide a knowledge base of international experience that can be used at country level to improve national health manpower planning approach. (aut. ref.)