Inequality in the Distribution of Healthcare Human Resources in Poland
Abstract
1. Introduction
2. Theory Background and Literature Review
3. The Characteristics of Polish Health Care System
4. Methodology
5. Results
6. Discussion
7. Conclusions
Supplementary Materials
Funding
Conflicts of Interest
References
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---|---|---|
Mantzavinis, G., Theodorakis, P. N., Lionis, Ch. and Trell, E. | trends in the inequalities in the distribution of general practitioners in Sweden [44]; | Lorenz Curve; Gini coefficients; |
Theodorakis, P.N., Mantzavinis, G.D., Rrumbullaku, L., Lionis, C., and Trell, E. | equity in distribution of primary care physician using population per physician ratio; comparison between Ioannina prefecture in Greece and Gjirokaster prefecture in Albania [45]; | Gini coefficient; |
Theodorakis, P.N., Mantzavinis, G.D., Rrumbullaku, L., Lionis, C., and Trell, E. | distribution of general practitioners with adjustment for mortality and consultation rates [46]; | Gini coefficient; Atkinson and Robin Hood indices; decile ratios; |
Johnston, G. and Wilkinson, D. | distribution of general practitioners (GPs) in Australia adjusted for community need (population size and crude mortality) [47]; | Robin Hood Index; |
Matsumoto, M., Inoue, K., Farmer, J., Inada, H. and Kajii, E. | geographic distribution of the physicians in each specialty and their associations with physician employment status in Japan, in comparison with the US [48]; | Gini coefficient; correlations; |
Gravelle, H. and Sutton, M. | comparison of geographical inequality in the distribution of general practitioners (GPs), other resources and mortality in England and Wales [49]; | decile ratio; Gini coefficient; Atkinson index; standard deviation; |
Pallikadavath, S., Singh, A., Ogollah, R., Dean, T. and Stones, W. | the extent of inequalities in human resource provision at India’s Heath Sub-Centres (HSC) [50]; | Gini coefficient; Theil index; |
Erdenee, O., Paramita, S.A., Yamazaki, Ch. and Koyama, H. | comparison of the distributions of health care resources (physicians, nurses, and hospital beds) in urban, suburban, and rural areas of Mongolia [51]; | Mann-Whitney U test; Gini coefficient; |
Rabbanikhah, F., Moradi, R., Mazaheri, E., Shahbazi, S., Barzegar, L. and Karyani, A.K. | geographical distribution of GPs in public health sector in Iran [52]; | descriptive statistics; Gini coefficient; |
Mobaraki, H., Hassani, A., Kashkalani, T., Khalilnejad, R., and Chimeh, E.E. | equity of human resources’ distribution among Iran’s medical science universities [53]; | Gini coefficient; Robin hood indexes; |
Sefiddashti, S.E., Mohammad Arab, M., Ghazanfari, S., Kazemi, Z., Rezaei, S., and Karyani, A.K. | inequality of in the allocation of human resources in the health sector in Teheran (specialists, general practitioners, pharmacists, paramedics, dentists, nurses and community health workers) [54]; | Gini coefficient; regression analysis; dissimilarity index; |
Paramita, S.A. Yamazaki, Ch., and Koyama, H. | distribution trends of physicians, puskesmas (community health centers), hospitals, and hospital beds in Indonesia [55]; | Gini coefficient; |
Li, D., Zhou, Z., Si Y., Xu Y., Shen Ch., Wang, Y. and Wang X. | distribution inequality of health human resources (doctors and nurses) in China; quantification of the contribution of economic-status to the total inequality [56]; | Concentration Index; |
Wu. J. and Yang, Y. | trends in the demographic and geographic distribution inequality of healthcare professionals (nurses and physicians) in China; contributions by intra-regional and inter-regional differences on total inequality in China [57]; | Gini coefficient; Theil index; |
Lu, L. and Zeng. J. | geographic and population distribution of hospital beds and doctors across different regions in China [58]; | Moran’s index local Moran’s index; Gini coefficient; Pearson correlation; |
Zhang, T., Xu, Y., Ren, J., Sun, L. and Liu, C. | distribution of numbers of institutions, health workers and beds; and outcomes such as per capita outpatient visits and annual hospitalization rates in China [59]; | Gini coefficient; Concentration Index; |
Jin, J., Wang, J., Ma, X., Wang, Y. and Li, R. | distribution of health care institutions, beds, medical personnel in China [60]; | Gini Coefficient; |
Kobayashi, Y. and Takaki, H. | geographic distribution of physicians in Japan [61]; | Gini coefficient; Lorenz Curve; |
Toyabe, S. | time trends in number and distribution of physicians (according to place of working as general hospitals, university hospitals and clinics) in Japan [62]; | Gini coefficient; Atkinson index; Theil index; |
Munga, M.A. and Maestad, O. | inequalities in the distribution of health workers in Tanzania [63]; | Lorenz Curve/ Gini coefficient; concentration index |
Wiseman, V., Lagarde, M., Batura, N., Lin, S., Irava, W. and Roberts G. | equity in the distribution of three categories of health workers: doctors, nurses, and all health workers (doctors, nurses, dentists and health support staff); population size and crude death rates are used as proxies for health care needs in Fiji [64]; | Lorenz Curve/ Gini coefficient; Theil Index; |
Tandi, T.E., Cho, Y.M., Akam, A.J-C., Afoh, Ch.O., Ryu, S.H., Choi, M.S., Kim, K.H. and Choi, J.W. | inequalities in the distribution of physicians, nurses and paramedics in Cameroon; comparison with outcome maternal mortality, under-five infant mortality and measles immunization coverage [65]; | Gini coefficient Lorenz curve; linear regression; concentration curves; |
Year | Physician | Dentist | Nurse | Pharmacist |
---|---|---|---|---|
2010 | 20.6 | 3.2 | 47.9 | 6.5 |
2011 | 20.9 | 3.3 | 48.4 | 6.8 |
2012 | 22.1 | 3.2 | 54.9 | 7.0 |
2013 | 22.1 | 3.2 | 52.1 | 7.1 |
2014 | 22.7 | 3.4 | 51.7 | 7.2 |
2015 | 23.0 | 3.3 | 51.4 | 7.3 |
2016 | 23.9 | 3.5 | 51.0 | 7.6 |
2017 | 23.5 | 3.5 | 50.4 | 7.6 |
change | 14.08% | 9.38% | 5.22% | 16.92% |
Year | Physician | Dentist | Nurse | Pharmacist |
---|---|---|---|---|
2010 | 0.254 | 0.039 | 0.591 | 0.080 |
2011 | 0.257 | 0.041 | 0.597 | 0.084 |
2012 | 0.272 | 0.040 | 0.677 | 0.086 |
2013 | 0.273 | 0.039 | 0.642 | 0.088 |
2014 | 0.280 | 0.042 | 0.637 | 0.089 |
2015 | 0.283 | 0.040 | 0.631 | 0.090 |
2016 | 0.293 | 0.043 | 0.626 | 0.094 |
2017 | 0.289 | 0.043 | 0.619 | 0.094 |
change | 13.80% | 8.15% | 4.85% | 16.76% |
Year | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | Change * |
---|---|---|---|---|---|---|---|---|---|
specialist in general | 13.81 | 15.20 | 15.16 | 15.01 | 15.47 | 15.60 | 15.84 | 15.64 | 13.26% |
anesthesiologist | 0.78 | 0.80 | 0.89 | 0.92 | 0.97 | 0.96 | 0.96 | 0.96 | 23.06% |
cardiologist | 0.45 | 0.47 | 0.53 | 0.55 | 0.63 | 0.71 | 0.76 | 0.76 | 67.44% |
dermatologist | 0.23 | 0.23 | 0.25 | 0.24 | 0.23 | 0.24 | 0.25 | 0.23 | 1.34% |
family medicine | 1.57 | 1.62 | 1.69 | 1.67 | 1,73 | 1.73 | 1.75 | 1.75 | 11.92% |
internist | 1.84 | 1.87 | 1.94 | 1.86 | 1.80 | 1.74 | 1.72 | 1.66 | −10.00% |
lung diseases | 0.33 | 0.34 | 0.36 | 0.35 | 0.35 | 0.36 | 0.35 | 0.33 | 0.48% |
neurologist | 0.54 | 0.58 | 0.62 | 0.60 | 0.54 | 0.62 | 0.64 | 0.63 | 15.32% |
obstetrics and gynecology | 1.01 | 1.01 | 1.02 | 0.99 | 1.00 | 0.99 | 1.02 | 0.97 | −4.13% |
occupational medicine | 0.21 | 0.22 | 0.21 | 0.20 | 0.16 | 0.19 | 0.21 | 0.21 | −1.06% |
oncologist | 0.09 | 0.10 | 0.12 | 0.13 | 0.13 | 0.18 | 0.19 | 0.19 | 115.51% |
ophthalmologist | 0.46 | 0.47 | 0.51 | 0.49 | 0.52 | 0.53 | 0.53 | 0.52 | 14.26% |
otolaryngology | 0.33 | 0.33 | 0.34 | 0.34 | 0.32 | 0.34 | 0.35 | 0.35 | 5.34% |
pediatrician | 0.84 | 0.84 | 0.84 | 0.84 | 0.86 | 0.88 | 0.94 | 0.93 | 10.67% |
psychiatrist | 0.52 | 0.58 | 0.60 | 0.62 | 0.59 | 0.65 | 0.64 | 0.64 | 22.47% |
radiologist | 0.51 | 0.52 | 0.59 | 0.59 | 0.59 | 0.60 | 0.58 | 0.59 | 15.96% |
surgeon | 1.94 | 1.98 | 2.18 | 2.13 | 2.20 | 2.21 | 2.24 | 2.18 | 12.45% |
Year | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | Change * |
---|---|---|---|---|---|---|---|---|---|
specialist in general | 0.169 | 0.173 | 0.187 | 0.185 | 0.190 | 0.192 | 0.195 | 0.192 | 14.05% |
anesthesiologist | 0.010 | 0.010 | 0.011 | 0.011 | 0.012 | 0.012 | 0.012 | 0.012 | 23.92% |
cardiologist | 0.006 | 0.006 | 0.006 | 0.007 | 0.008 | 0.009 | 0.009 | 0.009 | 68.60% |
dermatologist | 0.003 | 0.003 | 0.003 | 0.003 | 0.003 | 0.003 | 0.003 | 0.003 | 2.04% |
family medicine | 0.019 | 0.020 | 0.021 | 0.021 | 0.021 | 0.021 | 0.022 | 0.022 | 12.70% |
internist | 0.022 | 0.023 | 0.024 | 0.023 | 0.022 | 0.020 | 0.021 | 0.020 | −9.37% |
lung diseases | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 1.18% |
neurologist | 0.007 | 0.007 | 0.008 | 0.007 | 0.007 | 0.008 | 0.008 | 0.008 | 16.12% |
obstetrics and gynecology | 0.012 | 0.012 | 0.013 | 0.012 | 0.012 | 0.012 | 0.013 | 0.012 | −3.46% |
occupational medicine | 0.003 | 0.003 | 0.003 | 0.002 | 0.002 | 0.002 | 0.003 | 0.003 | −0.37% |
oncologist | 0.001 | 0.001 | 0.002 | 0.002 | 0.002 | 0.002 | 0.002 | 0.002 | 117.01% |
ophthalmologist | 0.006 | 0.006 | 0.006 | 0.006 | 0.006 | 0.006 | 0.006 | 0.006 | 15.06% |
otolaryngology | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 0.004 | 6.07% |
pediatrician | 0.010 | 0.010 | 0.010 | 0.010 | 0.011 | 0.011 | 0.012 | 0.011 | 11.44% |
psychiatrist | 0.006 | 0.007 | 0.007 | 0.008 | 0.007 | 0.008 | 0.008 | 0.008 | 23.33% |
radiologist | 0.006 | 0.006 | 0.007 | 0.007 | 0.007 | 0.007 | 0.007 | 0.007 | 16.77% |
surgeon | 0.024 | 0.024 | 0.027 | 0.026 | 0.027 | 0.027 | 0.028 | 0.027 | 13.23% |
Year | Physician | Dentist | Nurse | Pharmacist |
---|---|---|---|---|
2010 | 0.08 | 0.16 | 0.06 | 0.11 |
2011 | 0.08 | 0.17 | 0.06 | 0.10 |
2012 | 0.08 | 0.16 | 0.04 | 0.10 |
2013 | 0.07 | 0.16 | 0.05 | 0.09 |
2014 | 0.07 | 0.14 | 0.05 | 0.09 |
2015 | 0.07 | 0.14 | 0.06 | 0.09 |
2016 | 0.07 | 0.13 | 0.06 | 0.09 |
2017 | 0.06 | 0.14 | 0.07 | 0.09 |
Year | Physician | Dentist | Nurse | Pharmacist |
---|---|---|---|---|
2010 | 0.30 | 0.26 | 0.30 | 0.32 |
2011 | 0.30 | 0.27 | 0.30 | 0.32 |
2012 | 0.30 | 0.27 | 0.28 | 0.32 |
2013 | 0.29 | 0.26 | 0.28 | 0.31 |
2014 | 0.29 | 0.25 | 0.29 | 0.32 |
2015 | 0.30 | 0.29 | 0.29 | 0.31 |
2016 | 0.30 | 0.29 | 0.29 | 0.31 |
2017 | 0.30 | 0.27 | 0.29 | 0.30 |
Year | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 |
---|---|---|---|---|---|---|---|---|
specialist in general | 0.07 | 0.08 | 0.07 | 0.07 | 0.07 | 0.07 | 0.07 | 0.06 |
anesthesiologist | 0.07 | 0.07 | 0.06 | 0.08 | 0.07 | 0.07 | 0.06 | 0.07 |
cardiologist | 0.15 | 0.15 | 0.14 | 0.21 | 0.15 | 0.14 | 0.15 | 0.18 |
dermatologist | 0.12 | 0.14 | 0.12 | 0.15 | 0.12 | 0.12 | 0.13 | 0.12 |
family medicine | 0.22 | 0.22 | 0.20 | 0.21 | 0.19 | 0.19 | 0.19 | 0.18 |
internist | 0.11 | 0.12 | 0.10 | 0.10 | 0.12 | 0.12 | 0.12 | 0.12 |
lung diseases | 0.14 | 0.11 | 0.11 | 0.10 | 0.08 | 0.07 | 0.08 | 0.08 |
neurologist | 0.10 | 0.11 | 0.11 | 0.11 | 0.10 | 0.10 | 0.10 | 0.10 |
obstetrics and gynecology | 0.08 | 0.09 | 0.08 | 0.09 | 0.08 | 0.08 | 0.09 | 0.09 |
occupational medicine | 0.19 | 0.22 | 0.22 | 0.24 | 0.23 | 0.20 | 0.21 | 0.18 |
oncologist | 0.25 | 0.27 | 0.23 | 0.19 | 0.21 | 0.19 | 0.15 | 0.16 |
ophthalmologist | 0.12 | 0.12 | 0.11 | 0.13 | 0.12 | 0.12 | 0.12 | 0.10 |
otolaryngology | 0.09 | 0.08 | 0.09 | 0.10 | 0.09 | 0.08 | 0.09 | 0.11 |
pediatrician | 0.10 | 0.08 | 0.09 | 0.10 | 0.09 | 0.09 | 0.10 | 0.10 |
psychiatrist | 0.14 | 0.13 | 0.13 | 0.12 | 0.12 | 0.12 | 0.12 | 0.09 |
radiologist | 0.15 | 0.15 | 0.15 | 0.11 | 0.13 | 0.13 | 0.13 | 0.11 |
surgeon | 0.05 | 0.05 | 0.05 | 0.06 | 0.06 | 0.06 | 0.06 | 0.06 |
Year | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 |
---|---|---|---|---|---|---|---|---|
specialist in general | 0.29 | 0.29 | 0.28 | 0.29 | 0.29 | 0.29 | 0.29 | 0.29 |
anesthesiologist | 0.29 | 0.30 | 0.29 | 0.29 | 0.30 | 0.29 | 0.28 | 0.30 |
cardiologist | 0.37 | 0.38 | 0.37 | 0.37 | 0.37 | 0.38 | 0.37 | 0.37 |
dermatologist | 0.27 | 0.29 | 0.26 | 0.28 | 0.27 | 0.27 | 0.25 | 0.26 |
family medicine | 0.39 | 0.42 | 0.41 | 0.43 | 0.43 | 0.40 | 0.38 | 0.37 |
internist | 0.37 | 0.37 | 0.35 | 0.35 | 0.36 | 0.36 | 0.36 | 0.35 |
lung diseases | 0.30 | 0.30 | 0.29 | 0.30 | 0.28 | 0.28 | 0.29 | 0.30 |
neurologist | 0.32 | 0.32 | 0.32 | 0.31 | 0.32 | 0.32 | 0.31 | 0.31 |
obstetrics and gynecology | 0.25 | 0.26 | 0.27 | 0.26 | 0.26 | 0.26 | 0.26 | 0.26 |
occupational medicine | 0.38 | 0.39 | 0.39 | 0.41 | 0.41 | 0.38 | 0.37 | 0.36 |
oncologist | 0.38 | 0.42 | 0.39 | 0.36 | 0.38 | 0.38 | 0.35 | 0.33 |
ophthalmologist | 0.33 | 0.32 | 0.32 | 0.33 | 0.32 | 0.33 | 0.31 | 0.31 |
otolaryngology | 0.31 | 0.29 | 0.29 | 0.29 | 0.29 | 0.30 | 0.30 | 0.31 |
pediatrician | 0.30 | 0.30 | 0.30 | 0.31 | 0.32 | 0.31 | 0.31 | 0.32 |
psychiatrist | 0.31 | 0.32 | 0.31 | 0.30 | 0.30 | 0.31 | 0.31 | 0.31 |
radiologist | 0.32 | 0.32 | 0.32 | 0.31 | 0.32 | 0.31 | 0.32 | 0.32 |
surgeon | 0.29 | 0.29 | 0.28 | 0.28 | 0.28 | 0.28 | 0.28 | 0.28 |
Types of Healthcare Human Resources | Theil Index | Contribution Rate | |||||||
---|---|---|---|---|---|---|---|---|---|
Poland | Central | South West | North West | South | North | East | Within Groups | Among Groups | |
dentist | 0.171 | 0.009 | 0.006 | 0.431 | 0.012 | 0.001 | 0.003 | 47.25% | 52.75% |
pharmacist | 0.079 | 0.002 | 0.004 | 0.012 | 0.000 | 0.015 | 0.012 | 10.16% | 89.84% |
physician | 0.093 | 0.000 | 0.000 | 0.019 | 0.000 | 0.002 | 0.002 | 3.75% | 96.25% |
nurse | 0.088 | 0.001 | 0.000 | 0.003 | 0.000 | 0.005 | 0.001 | 1.71% | 98.29% |
specialist in general | 0.009 | 0.000 | 0.000 | 0.023 | 0.001 | 0.004 | 0.002 | 52.56% | 47.44% |
anesthesiologist | 0.010 | 0.002 | 0.002 | 0.002 | 0.006 | 0.007 | 0.016 | 59.89% | 40.11% |
cardiologist | 0.040 | 0.006 | 0.000 | 0.023 | 0.001 | 0.018 | 0.015 | 25.80% | 74.20% |
dermatologist | 0.028 | 0.002 | 0.000 | 0.113 | 0.013 | 0.007 | 0.008 | 83.84% | 16.16% |
family medicine | 0.054 | 0.000 | 0.001 | 0.126 | 0.018 | 0.002 | 0.031 | 54.69% | 45.31% |
internist | 0.022 | 0.007 | 0.003 | 0.013 | 0.003 | 0.002 | 0.004 | 24.05% | 75.95% |
lung diseases | 0.011 | 0.004 | 0.003 | 0.010 | 0.002 | 0.006 | 0.007 | 46.71% | 53.29% |
neurologist | 0.019 | 0.009 | 0.001 | 0.006 | 0.006 | 0.000 | 0.008 | 29.54% | 70.46% |
obstetrics and gynecology | 0.012 | 0.003 | 0.022 | 0.032 | 0.002 | 0.018 | 0.001 | 92.78% | 7.22% |
occupational medicine | 0.054 | 0.000 | 0.005 | 0.044 | 0.035 | 0.073 | 0.083 | 75.03% | 24.97% |
oncologist | 0.039 | 0.031 | 0.033 | 0.006 | 0.001 | 0.017 | 0.028 | 46.80% | 53.20% |
ophthalmologist | 0.022 | 0.001 | 0.001 | 0.064 | 0.017 | 0.003 | 0.008 | 72.12% | 27.88% |
otolaryngology | 0.017 | 0.002 | 0.003 | 0.031 | 0.008 | 0.010 | 0.026 | 78.58% | 21.42% |
pediatrician | 0.016 | 0.006 | 0.003 | 0.005 | 0.001 | 0.006 | 0.007 | 28.94% | 71.06% |
psychiatrist | 0.016 | 0.002 | 0.001 | 0.012 | 0.001 | 0.010 | 0.009 | 36.83% | 63.17% |
surgeon | 0.007 | 0.000 | 0.003 | 0.015 | 0.002 | 0.007 | 0.005 | 72.44% | 27.56% |
radiologist | 0.019 | 0.001 | 0.087 | 0.007 | 0.011 | 0.017 | 0.005 | 83.88% | 16.12% |
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Rój, J. Inequality in the Distribution of Healthcare Human Resources in Poland. Sustainability 2020, 12, 2043. https://doi.org/10.3390/su12052043
Rój J. Inequality in the Distribution of Healthcare Human Resources in Poland. Sustainability. 2020; 12(5):2043. https://doi.org/10.3390/su12052043
Chicago/Turabian StyleRój, Justyna. 2020. "Inequality in the Distribution of Healthcare Human Resources in Poland" Sustainability 12, no. 5: 2043. https://doi.org/10.3390/su12052043
APA StyleRój, J. (2020). Inequality in the Distribution of Healthcare Human Resources in Poland. Sustainability, 12(5), 2043. https://doi.org/10.3390/su12052043