Special Issue "The Future Health Workforce: Integrated Solutions and Models of Care"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: 15 February 2021.

Special Issue Editors

Dr. Madhan Balasubramanian
Website
Guest Editor
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
Interests: health services and health systems (including practice patterns, service provision, health workforce, integrated care); future trends in health care (including e-health, electronic health records, innovations); methodological issues (including mixed methods, national surveys, data linkage)
Special Issues and Collections in MDPI journals
Prof. Stephanie Short
Website
Guest Editor
The University of Sydney, Sydney, Australia
Interests: health governance; public policy; health systems

Special Issue Information

Dear Colleagues,

The health workforce is a vital aspect of health systems, both essential in improving population/patient health outcomes and towards addressing contemporary issues such as universal health coverage (UHC) and sustainable development goals (SDGs). There is an increasing body of research that indicates if the health workforce were to be redesigned from the ground up—based on population needs—we would end up with a different configuration of the health workforce! This makes us wonder if one could design or develop innovative health workforce solution(s) for the future that is more responsive to meet population needs.

The 21st century presents several challenges to the health workforce and the health professions that require thoughtful consideration and analysis, to meet population needs. Health inequalities continue to exist both across and within countries, especially affecting vulnerable and disadvantaged groups. Disease patterns are changing, with a rise in chronic conditions and non-communicable diseases. An increased life expectancy also presents us with the challenge of meeting care provisions for an ageing population. Workforce shortages, geographic maldistribution and international migration are omnipresent.

Health workforce solutions have been diverse and dependent on country- or context-specific scenarios. New health workforce personnel, as well as an improving scope of practice of existing personnel, have been widely debated as solutions. Of importance has been how different health personnel groups can work collaboratively as a team, and at different levels such as primary, secondary and tertiary care. Models of care specific to population groups (e.g. older people, children) as well as disease conditions (e.g. cancer, rehabilitation, oral health) are emerging, but with varied success.

In this special issue in the International Journal of Environmental Research and Public Health, we plan to bring together research that debates/provides innovative health workforce solutions directed towards meeting population needs, either in the form of integrated solutions or models of care. We also welcome articles that cover challenges at an education or regulation level required to facilitate such innovative health workforce solutions. Titled The Future Health Workforce: Integrated Solutions and Models of Care”—we plan to include a wide range of health workforce articles that spreads across all health professions or disciplines (medicine, nursing, pharmacy, dentistry and allied health). We encourage both quantitative as well as qualitative research articles, as well as systematic reviews. Well written articles displaying methodological rigor will be preferred. We welcome articles from different countries (low, middle and high income) as well as different contexts (populations or diseases).  

We thank you for your interest in the special issue and look forward towards hearing from you.

 

Dr. Madhan Balasubramanian
Prof. Stephanie Short
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health workforce
  • integrated care
  • models of care
  • workforce planning
  • patient-centric care
  • workforce policy
  • interdisciplinary education
  • collaborative practice
  • teamwork

Published Papers (9 papers)

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Research

Open AccessArticle
Job Attractiveness and Job Satisfaction of Dental Hygienists: From Japanese Dental Hygienists’ Survey 2019
Int. J. Environ. Res. Public Health 2021, 18(2), 755; https://doi.org/10.3390/ijerph18020755 - 17 Jan 2021
Abstract
Job attractiveness and job satisfaction are important factors in the continuity of employment among healthcare professionals. The aim of this study was to assess job satisfaction and job attractiveness among dental hygienists in Japan. The Japan Dental Hygienists Association conducted a survey of [...] Read more.
Job attractiveness and job satisfaction are important factors in the continuity of employment among healthcare professionals. The aim of this study was to assess job satisfaction and job attractiveness among dental hygienists in Japan. The Japan Dental Hygienists Association conducted a survey of the employment status of Japanese dental hygienists in 2019. Questionnaires were distributed to all 16,722 members, and 8932 were returned (Collection rate: 53.4%). Data from 7869 currently working dental hygienists were analysed in this study. We analysed seven items of job attractiveness, 14 items of job satisfaction, and 13 items of request for improving the working environment. Item response theory and structural equation modelling (SEM) were utilized for the analysis. For attractiveness of dental hygienists’ work, respondents placed greater emphasis on the fact that dental hygienists needed national qualifications rather than on income stability. SEM showed that job satisfaction consisted of two factors, ‘Value for work’ and ‘Working environment’, as did job attractiveness, with ‘Contribution’ and ‘Assured income’. Value for work affects the contribution to people, and, employment environment affects assured income. Improving job satisfaction and work environments could help to improve the employment rate of dental hygienists, which could positively influence patient care. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessFeature PaperArticle
A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career
Int. J. Environ. Res. Public Health 2020, 17(22), 8566; https://doi.org/10.3390/ijerph17228566 - 18 Nov 2020
Abstract
There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when [...] Read more.
There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors’ choice to be a generalist or specialist. We interviewed 32 Australian doctors (graduates of a large university medical school) who had decided on a generalist (GP/public health) or specialist (all other specialties) career. They reflected on their personal responses to experiences at different times to stimulate their choice. Theory was refined and confirmed by testing it with 17 additional doctors of various specialties/career stages and by referring to wider literature. Our final theory showed the decision involved multi-level contextual factors intersecting with eight triggers to produce either a specialist or generalist choice. Both clinical and place-based exposures, as well as attributes, skills, norms and status of different fields affected choice. This occurred relative to the interests and expectations of different doctors, including their values for professional, socio-economic and lifestyle rewards, often intersecting with issues like gender and life stage. Applying this theory, it is possible to tailor selection and ongoing exposures to yield more generalists. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessFeature PaperArticle
A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System
Int. J. Environ. Res. Public Health 2020, 17(18), 6913; https://doi.org/10.3390/ijerph17186913 - 22 Sep 2020
Abstract
Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance [...] Read more.
Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessArticle
New Ways of Working? A Rapid Exploration of Emerging Evidence Regarding the Care of Older People during COVID19
Int. J. Environ. Res. Public Health 2020, 17(18), 6442; https://doi.org/10.3390/ijerph17186442 - 04 Sep 2020
Cited by 1
Abstract
Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this [...] Read more.
Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this period. We conducted an exploration of the emerging evidence within the timeframe of 1 March 2020 to 11 May 2020. To capture a broad perspective, we undertook thematic analysis of Twitter data which was extracted through a broad search for new ways of working in health and social care. For a more in-depth focus on the health and social care of older people, we undertook a systematic scoping of newspapers using the Nexis UK database. We undertook a validation workshop with members of the interprofessional working group of the Irish National Integrated Care Programme for Older People, and with researchers. A total of 317 tweets were extracted related to six new ways of working. There was evidence of using telehealth to provide ongoing care to patients; interprofessional work; team meetings using online platforms; trust and collaboration within teams; as well as teams feeling empowered to change at a local level. 34 newspaper articles were extracted related to new ways of working in the care of older people, originating in England (n = 17), Wales (n = 6), Scotland (n = 6), Ireland (n = 4) and Germany (n = 1). Four main themes were captured that focused on role expansion, innovations in communication, environmental restructuring and enablement. The results of this exploration of emerging evidence show that health and social care teams can transform very rapidly. Much of the change was based on goodwill as a response to the pandemic. Further analysis of empirical evidence of changing practices should include the perspectives of older people and should capture the resources needed to sustain innovations, as well as evaluate gaps in service provision. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessArticle
Context Matters: Findings from a Qualitative Study Exploring Service and Place Factors Influencing the Recruitment and Retention of Allied Health Professionals in Rural Australian Public Health Services
Int. J. Environ. Res. Public Health 2020, 17(16), 5815; https://doi.org/10.3390/ijerph17165815 - 11 Aug 2020
Cited by 1
Abstract
Chronic health workforce shortages significantly contribute to unmet health care needs in rural and remote communities. Of particular and growing concern are shortages of allied health professionals (AHPs). This study explored the contextual factors impacting the recruitment and retention of AHPs in rural [...] Read more.
Chronic health workforce shortages significantly contribute to unmet health care needs in rural and remote communities. Of particular and growing concern are shortages of allied health professionals (AHPs). This study explored the contextual factors impacting the recruitment and retention of AHPs in rural Australia. A qualitative approach using a constructivist-interpretivist methodology was taken. Semi-structured interviews (n = 74) with executive staff, allied health (AH) managers and newly recruited AHPs working in two rural public health services in Victoria, Australia were conducted. Data was coded and categorised inductively and analysed thematically. The findings suggest that to support a stable and sustainable AH workforce, rural public sector health services need to be more efficient, strategic and visionary. This means ensuring that policies and procedures are equitable and accessible, processes are effective, and action is taken to develop local programs, opportunities and supports that allow AH staff to thrive and grow in place at all grade levels and life stages. This study reinforces the need for a whole-of-community approach to effectively support individual AH workers and their family members in adjusting to a new place and developing a sense of belonging in place. The recommendations arising from this study are likely to have utility for other high-income countries, particularly in guiding AH recruitment and retention strategies in rural public sector health services. Recommendations relating to community/place will likely benefit broader rural health workforce initiatives. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessArticle
Faculties to Support General Practitioners Working Rurally at Broader Scope: A National Cross-Sectional Study of Their Value
Int. J. Environ. Res. Public Health 2020, 17(13), 4652; https://doi.org/10.3390/ijerph17134652 - 28 Jun 2020
Cited by 2
Abstract
Strategies are urgently needed to foster rural general practitioners (GPs) with the skills and professional support required to adequately address healthcare needs in smaller, often isolated communities. Australia has uniquely developed two national-scale faculties that target rural practice: the Fellowship in Advanced Rural [...] Read more.
Strategies are urgently needed to foster rural general practitioners (GPs) with the skills and professional support required to adequately address healthcare needs in smaller, often isolated communities. Australia has uniquely developed two national-scale faculties that target rural practice: the Fellowship in Advanced Rural General Practice (FARGP) and the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM). This study evaluates the benefit of rural faculties for supporting GPs practicing rurally and at a broader scope. Data came from an annual national survey of Australian doctors from 2008 and 2017, providing a cross-sectional design. Work location (rurality) and scope of practice were compared between FACRRM and FARGP members, as well as standard non-members. FACRRMs mostly worked rurally (75–84%, odds ratio (OR) 8.7, 5.8–13.1), including in smaller rural communities (<15,000 population) (41–54%, OR 3.5, 2.3–5.3). FARGPs also mostly worked in rural communities (56–67%, OR 4.2, 2.2–7.8), but fewer in smaller communities (25–41%, OR 1.1, 0.5–2.5). Both FACRRMs and FARGPs were more likely to use advanced skills, especially procedural skills. GPs with fellowship of a rural faculty were associated with significantly improved geographic distribution and expanded scope, compared with standard GPs. Given their strong outcomes, expanding rural faculties is likely to be a critical strategy to building and sustaining a general practice workforce that meets the needs of rural communities. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
Open AccessArticle
Workers’ Healthcare Assistance Model (WHAM): Development, Validation, and Assessment of Sustainable Return on Investment (S-ROI)
Int. J. Environ. Res. Public Health 2020, 17(9), 3143; https://doi.org/10.3390/ijerph17093143 - 30 Apr 2020
Abstract
The present study aimed to present and validate the Worker´s Healthcare Assistance Model (WHAM), which includes an interdisciplinary approach to health risk management in search of integral and integrated health, considering economic sustainability. Through the integration of distinct methodological strategies, WHAM was developed [...] Read more.
The present study aimed to present and validate the Worker´s Healthcare Assistance Model (WHAM), which includes an interdisciplinary approach to health risk management in search of integral and integrated health, considering economic sustainability. Through the integration of distinct methodological strategies, WHAM was developed in the period from 2011 to 2018, in a workers’ occupational health centre in the oil industry in Bahia, Brazil. The study included a sample of 965 workers, 91.7% of which were men, with a mean age of 44.9 years (age ranged from 23 to 73 years). The Kendall rank correlation coefficient and hierarchical multiple regression analysis were used for the validation of WHAM. The assessment of sustainable return on investment (S-ROI) was made using the WELLCAST ROI™ decision support tool, covering workers with heart disease and diabetes. WHAM can be considered an innovative healthcare model, as there is no available comparative model. WHAM is considered robust, with 86% health risk explanatory capacity and with an 85.5% S-ROI. It can be concluded that WHAM is a model capable of enhancing the level of workers’ health in companies, reducing costs for employers and improving the quality of life within the organization. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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Open AccessArticle
The Challenges of Public Health, Social Work, and Psychological Counselling Services in South Korea: The Issues of Limited Support and Resource
Int. J. Environ. Res. Public Health 2020, 17(8), 2771; https://doi.org/10.3390/ijerph17082771 - 17 Apr 2020
Cited by 7
Abstract
Public health, social work, and psychological counselling professions in South Korea are facing challenges of human resource shortage and shortage of professionals who can provide multilingual services. The purpose of this study was to explore and understand why public health, social work, and [...] Read more.
Public health, social work, and psychological counselling professions in South Korea are facing challenges of human resource shortage and shortage of professionals who can provide multilingual services. The purpose of this study was to explore and understand why public health, social work, and psychological counselling services degree graduates and professionals with multilingual skills in South Korea decide to leave their professional field to the hospitality and business industries, particularly for those who completed their initial training at one of the international universities. Based on the approach of the Social Cognitive Career Theory, individuals’ self-efficacy, outcome expectations, interests, and goals were examined and considered. The data were collected from 12 participants with the methodology of interpretative phenomenological analysis. The general inductive approach was employed to categorize the themes for reporting. The results indicated that public health, social work, and psychological counselling services-related positions are not available, modelling from peers, and lack of career development skills are the primary difficulties of public health, social work, and psychological counselling services graduates. The completion of this study provides clear recommendations to educators, policymakers, school leaders, human resource planners, and university administrators to improve their curricula and school counselling for public health, social work, and psychological counselling services graduates and the next generation. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
Open AccessArticle
The Future of Careers at the Intersection of Climate Change and Public Health: What Can Job Postings and an Employer Survey Tell Us?
Int. J. Environ. Res. Public Health 2020, 17(4), 1310; https://doi.org/10.3390/ijerph17041310 - 18 Feb 2020
Cited by 1
Abstract
Climate change is acknowledged to be a major risk to public health. Skills and competencies related to climate change are becoming a part of the curriculum at schools of public health and are now a competency required by schools in Europe and Australia. [...] Read more.
Climate change is acknowledged to be a major risk to public health. Skills and competencies related to climate change are becoming a part of the curriculum at schools of public health and are now a competency required by schools in Europe and Australia. However, it is unclear whether graduates of public health programs focusing on climate change are in demand in the current job market. The authors analyzed current job postings, 16 years worth of job postings on a public health job board, and survey responses from prospective employers. The current job market appears small but there is evidence from job postings that it may be growing, and 91.7% of survey respondents believe the need for public health professionals with training in climate change may grow in the next 5–10 years. Current employers value skills/competencies such as the knowledge of climate mitigation/adaptation, climate-health justice, direct/indirect and downstream effects of climate on health, health impact assessment, risk assessment, pollution-health consequences and causes, Geographic Information System (GIS) mapping, communication/writing, finance/economics, policy analysis, systems thinking, and interdisciplinary understanding. Ensuring that competencies align with current and future needs is a key aspect of curriculum development. At the same time, we recognize that while we attempt to predict future workforce needs with historical data or surveys, the disruptive reality created by climate change cannot be modeled from prior trends, and we must therefore adopt new paradigms of education for the emerging future. Full article
(This article belongs to the Special Issue The Future Health Workforce: Integrated Solutions and Models of Care)
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