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. Jean Spinks & Susan Nancarrow & Sue McAvoy & Lisa Nissen, 2024. "Does Medicare Support Multidisciplinary Teams Working to the Top of Their Ticket?," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 57(2), pages 179-186, June.
    2. 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.
    3. 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).
    4. 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. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. Yvonne Zurynski & Georgia Fisher & Shalini Wijekulasuriya & Elle Leask & Putu Novi Arfirsta Dharmayani & Louise A. Ellis & Carolynn L. Smith & Jeffrey Braithwaite, 2024. "Bolstering health systems to cope with the impacts of climate change events: A review of the evidence on workforce planning, upskilling, and capacity building," International Journal of Health Planning and Management, Wiley Blackwell, vol. 39(3), pages 781-805, May.
    9. 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.
    10. 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.
    11. 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.
    12. Polin, Katherine & Hjortland, Maximilien & Maresso, Anna & van Ginneken, Ewout & Busse, Reinhard & Quentin, Wilm, 2021. "“Top-Three” health reforms in 31 high-income countries in 2018 and 2019: an expert informed overview," Health Policy, Elsevier, vol. 125(7), pages 815-832.
    13. Márta Péntek & Ottó Hajdu & Fanni Rencz & Zsuzsanna Beretzky & Valentin Brodszky & Petra Baji & Zsombor Zrubka & Klára Major & László Gulácsi, 2019. "Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 17-30, June.
    14. Chih-Hao Yang & Yen-Yu Liu & Chia-Hsin Chiang & Ya-Wen Su, 2023. "National IoMT platform strategy portfolio decision model under the COVID-19 environment: based on the financial and non-financial value view," Annals of Operations Research, Springer, vol. 328(1), pages 1151-1179, September.
    15. Scheil-Adlung, Xenia., 2015. "Long-term care protection for older persons : a review of coverage deficits in 46 countries," ILO Working Papers 994886493402676, International Labour Organization.
    16. Domagała, Alicja & Klich, Jacek, 2018. "Planning of Polish physician workforce – Systemic inconsistencies, challenges and possible ways forward," Health Policy, Elsevier, vol. 122(2), pages 102-108.
    17. Stephen Birch & Gail Tomblin Murphy & Adrian MacKenzie & William Whittaker & Thomas Mason, 2017. "Will the Need‐Based Planning of Health Human Resources Currently Undertaken in Several Countries Lead to Excess Supply and Inefficiency? A Comment on Basu and Pak," Health Economics, John Wiley & Sons, Ltd., vol. 26(6), pages 818-821, June.
    18. Chojnicki, Xavier & Moullan, Yasser, 2018. "Is there a ‘pig cycle’ in the labour supply of doctors? How training and immigration policies respond to physician shortages," Social Science & Medicine, Elsevier, vol. 200(C), pages 227-237.
    19. Correia, Tiago & Gomes, Inês & Nunes, Patrícia & Dussault, Gilles, 2020. "Health workforce monitoring in Portugal: Does it support strategic planning and policy-making?," Health Policy, Elsevier, vol. 124(3), pages 303-310.
    20. Till Bärnighausen & David Bloom, 2009. "Changing Research Perspectives on the Global Health Workforce," PGDA Working Papers 4609, Program on the Global Demography of Aging.

    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.