IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v250y2020ics0277953620300824.html
   My bibliography  Save this article

Opportunities for, and implications of, skill mix changes in health care pathways: Pay, productivity and practice variations in a needs-based planning framework

Author

Listed:
  • Birch, Stephen
  • Gibson, Jon
  • McBride, Anne

Abstract

Health workforce planning is traditionally based on demographically-driven ‘silo-based’ models in which future requirements for particular health professions are determined by applying estimates of the future population to the existing population-based level of workforce supply. Estimates of future workforce requirements are focused on, and constrained by population size and requirements increase monotonically. Key failures of existing models include (1) lack of integration between planning the health care workforce, health care services and health care funding and (2) lack of integration between planning different health care inputs and the potential for substitution between inputs. Hence planning models fail to incorporate emerging developments in healthcare delivery and workforce change. We present an integrated needs-based framework for health workforce planning and apply the framework using data from nine European countries to explore the workforce and financial implications of re-configuring the delivery of care through changes in the allocation of treatment tasks between health care professions (skill mix). We show that cost consequences depend not only on pay differences. Instead, workforce planning in rapidly changing workforce environments must consider and incorporate between-provider group differences in productivity (the number of patients that are served per fixed period of time) and practice style (the number and mix of tasks used in providing care to the same type of patient).

Suggested Citation

  • Birch, Stephen & Gibson, Jon & McBride, Anne, 2020. "Opportunities for, and implications of, skill mix changes in health care pathways: Pay, productivity and practice variations in a needs-based planning framework," Social Science & Medicine, Elsevier, vol. 250(C).
    • Handle: RePEc:eee:socmed:v:250:y:2020:i:c:s0277953620300824
    DOI: 10.1016/j.socscimed.2020.112863
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620300824
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2020.112863?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Maier, Claudia B. & Batenburg, Ronald & Birch, Stephen & Zander, Britta & Elliott, Robert & Busse, Reinhard, 2018. "Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?," Health Policy, Elsevier, vol. 122(10), pages 1085-1092.
    2. Kroezen, Marieke & Van Hoegaerden, Michel & Batenburg, Ronald, 2018. "The Joint Action on Health Workforce Planning and Forecasting: Results of a European programme to improve health workforce policies," Health Policy, Elsevier, vol. 122(2), pages 87-93.
    3. Tomoko Ono & Gaétan Lafortune & Michael Schoenstein, 2013. "Health Workforce Planning in OECD Countries: A Review of 26 Projection Models from 18 Countries," OECD Health Working Papers 62, OECD Publishing.
    4. Stephen Birch & George Kephart & Gail Tomblin-Murphy & Linda O'Brien-Pallas & Rob Alder & Adrian MacKenzie, 2007. "Human Resources Planning and the Production of Health: A Needs-Based Analytical Framework," Canadian Public Policy, University of Toronto Press, vol. 33(s1), pages 1-16, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. James Avoka Asamani & Christmal Dela Christmals & Gerda Marie Reitsma, 2021. "Advancing the Population Needs-Based Health Workforce Planning Methodology: A Simulation Tool for Country Application," IJERPH, MDPI, vol. 18(4), pages 1-20, February.
    2. Lenzen, Sabrina & Birch, Stephen, 2023. "From population numbers to population needs: Incorporating epidemiological change into health service planning in Australia," Social Science & Medicine, Elsevier, vol. 328(C).
    3. James Avoka Asamani & Christmal Dela Christmals & Gerda Marie Reitsma, 2021. "Modelling the supply and need for health professionals for primary health care in Ghana: Implications for health professions education and employment planning," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-26, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sutton, Claire & Prowse, Julie & McVey, Lynn & Elshehaly, Mai & Neagu, Daniel & Montague, Jane & Alvarado, Natasha & Tissiman, Chris & O'Connell, Kate & Eyers, Emma & Faisal, Muhammad & Randell, Rebec, 2023. "Strategic workforce planning in health and social care – an international perspective: A scoping review," Health Policy, Elsevier, vol. 132(C).
    2. Keegan, Conor & Brick, Aoife & García-Rodríguez, Abián & Hill, Leonie, 2022. "Projections of workforce requirements for public acute hospitals in Ireland, 2019–2035: a regional analysis based on the hippocrates model," Research Series, Economic and Social Research Institute (ESRI), number RS147, June.
    3. Maier, Claudia B. & Batenburg, Ronald & Birch, Stephen & Zander, Britta & Elliott, Robert & Busse, Reinhard, 2018. "Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?," Health Policy, Elsevier, vol. 122(10), pages 1085-1092.
    4. Claudio Costa & Maria Grazia Franco & Domenico Mantoan, 2018. "La previsione del fabbisogno formativo di professionisti sanitari: l?approccio integrato basato sull?offerta e sulla domanda determinata attraverso il sistema ACG," MECOSAN, FrancoAngeli Editore, vol. 2018(108), pages 101-121.
    5. Kamila Parzonka & Costase Ndayishimiye & Alicja Domagała, 2023. "Methods and Tools Used to Estimate the Shortages of Medical Staff in European Countries—Scoping Review," IJERPH, MDPI, vol. 20(4), pages 1-20, February.
    6. Asada, Yukiko & Kephart, George & Hurley, Jeremiah & Yoshida, Yoko & Smith, Andrea & Bornstein, Stephen, 2012. "The role of proximity to death in need-based approaches to health care," Health Policy, Elsevier, vol. 106(3), pages 291-302.
    7. Zhenyu Sun & Ying Sun & Xueyi Liu & Yixue Tu & Shaofan Chen & Dongfu Qian, 2022. "A Refined Evaluation Analysis of Global Healthcare Accessibility Based on the Healthcare Accessibility Index Model and Coupling Coordination Degree Model," Sustainability, MDPI, vol. 14(16), pages 1-16, August.
    8. Kroezen, Marieke & Schäfer, Willemijn & Sermeus, Walter & Hansen, Johan & Batenburg, Ronald, 2018. "Healthcare assistants in EU Member States: An overview," Health Policy, Elsevier, vol. 122(10), pages 1109-1117.
    9. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2020. "Planning health care capacities with a gravity equation," Ruhr Economic Papers 888, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    10. Zuraida Abal Abas & Mohamad Raziff Ramli & Mohamad Ishak Desa & Nordin Saleh & Ainul Nadziha Hanafiah & Nuraini Aziz & Zaheera Zainal Abidin & Abdul Samad Shibghatullah & Ahmad Fadzli Nizam Abdul Rahm, 2018. "A supply model for nurse workforce projection in Malaysia," Health Care Management Science, Springer, vol. 21(4), pages 573-586, December.
    11. Katarzyna Dubas‐Jakóbczyk & Alicja Domagała & Marcin Mikos, 2019. "Impact of the doctor deficit on hospital management in Poland: A mixed‐method study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 187-195, January.
    12. Sung-Hee Jeon & Jeremiah Hurley, 2010. "Physician Resource Planning in Canada: The Need for a Stronger Behavioural Foundation," Canadian Public Policy, University of Toronto Press, vol. 36(3), pages 359-375, September.
    13. Till Bärnighausen & David E. Bloom, 2009. "Changing Research Perspectives on the Global Health Workforce," NBER Working Papers 15168, National Bureau of Economic Research, Inc.
    14. Taylor, Francesca & Drennan, Vari M & Halter, Mary & Calestani, Melania, 2020. "Integration and retention of American physician assistants/associates working in English hospitals: A qualitative study," Health Policy, Elsevier, vol. 124(5), pages 525-530.
    15. van de Bovenkamp, Hester & van Pijkeren, Nienke & Ree, Eline & Aase, Ingunn & Johannessen, Terese & Vollaard, Hans & Wallenburg, Iris & Bal, Roland & Wiig, Siri, 2023. "Creativity at the margins: A cross-country case study on how Dutch and Norwegian peripheries address challenges to quality work in care for older persons," Health Policy, Elsevier, vol. 127(C), pages 66-73.
    16. Anna-Theresa Renner & Dieter Pennerstorfer, 2020. "Modeling inter-regional patient mobility: Does distance go far enough?," Economics working papers 2020-04, Department of Economics, Johannes Kepler University Linz, Austria.
    17. Anderson, Michael & O'Neill, Ciaran & Macleod Clark, Jill & Street, Andrew & Woods, Michael & Johnston-Webber, Charlotte & Charlesworth, Anita & Whyte, Moira & Foster, Margaret & Majeed, Azeem & Pitch, 2021. "Securing a sustainable and fit-for-purpose UK health and care workforce," LSE Research Online Documents on Economics 110809, London School of Economics and Political Science, LSE Library.
    18. Whittaker, William & Birch, Stephen & MacKenzie, Adrian & Murphy, Gail Tomblin, 2016. "Cohort effects on the need for health care and implications for health care planning in Canada," Health Policy, Elsevier, vol. 120(1), pages 81-88.
    19. Madhan Balasubramanian & Aliya Hasan & Suruchi Ganbavale & Anfal Alolayah & Jennifer Gallagher, 2021. "Planning the Future Oral Health Workforce: A Rapid Review of Supply, Demand and Need Models, Data Sources and Skill Mix Considerations," IJERPH, MDPI, vol. 18(6), pages 1-33, March.
    20. Correia, Tiago & Dussault, Gilles & Pontes, Carla, 2015. "The impact of the financial crisis on human resources for health policies in three southern-Europe countries," Health Policy, Elsevier, vol. 119(12), pages 1600-1605.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:250:y:2020:i:c:s0277953620300824. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.