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      Handling healthcare workforce planning with care: where do we stand?

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          Abstract

          Background

          Planning the health-care workforce required to meet the health needs of the population, while providing service levels that maximize the outcome and minimize the financial costs, is a complex task. The problem can be described as assessing the right number of people with the right skills in the right place at the right time, to provide the right services to the right people. The literature available on the subject is vast but sparse, with no consensus established on a definite methodology and technique, making it difficult for the analyst or policy maker to adopt the recent developments or for the academic researcher to improve such a critical field.

          Methods

          We revisited more than 60 years of documented research to better understand the chronological and historical evolution of the area and the methodologies that have stood the test of time. The literature review was conducted in electronic publication databases and focuses on conceptual methodologies rather than techniques.

          Results

          Four different and widely used approaches were found within the scope of supply and three within demand. We elaborated a map systematizing advantages, limitations and assumptions. Moreover, we provide a list of the data requirements necessary to implement each of the methodologies. We have also identified past and current trends in the field and elaborated a proposal on how to integrate the different methodologies.

          Conclusion

          Methodologies abound, but there is still no definite approach to address HHR planning. Recent literature suggests that an integrated approach is the way to solve such a complex problem, as it combines elements both from supply and demand, and more effort should be put in improving that proposal.

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          Most cited references67

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          The World Health Report 2006: working together for health.

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            Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication.

            To compare the relative effects on performance of sleep deprivation and alcohol. Performance effects were studied in the same subjects over a period of 28 hours of sleep deprivation and after measured doses of alcohol up to about 0.1% blood alcohol concentration (BAC). There were 39 subjects, 30 employees from the transport industry and nine from the army. After 17-19 hours without sleep, corresponding to 2230 and 0100, performance on some tests was equivalent or worse than that at a BAC of 0.05%. Response speeds were up to 50% slower for some tests and accuracy measures were significantly poorer than at this level of alcohol. After longer periods without sleep, performance reached levels equivalent to the maximum alcohol dose given to subjects (BAC of 0. 1%). These findings reinforce the evidence that the fatigue of sleep deprivation is an important factor likely to compromise performance of speed and accuracy of the kind needed for safety on the road and in other industrial settings.
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              Effects of policy options for human resources for health: an analysis of systematic reviews.

              Policy makers face challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services, especially in countries with low and middle incomes. We aimed to identify all available policy options to address human resources for health in such countries, and to assess the effectiveness of these policy options. We searched Medline and Embase from 1979 to September, 2006, the Cochrane Library, and the Human Resources for Health Global Resource Center database. We also searched up to 10 years of archives from five relevant journals, and consulted experts. We included systematic reviews in English which assessed the effects of policy options that could affect the training, distribution, regulation, financing, management, organisation, or performance of health workers. Two reviewers independently assessed each review for eligibility and quality, and systematically extracted data about main effects. We also assessed whether the policy options were equitable in their effects; suitable for scaling up; and applicable to countries with low and middle incomes. 28 of the 759 systematic reviews of effects that we identified were eligible according to our criteria. Of these, only a few included studies from countries with low and middle incomes, and some reviews were of low quality. Most evidence focused on organisational mechanisms for human resources, such as substitution or shifting tasks between different types of health workers, or extension of their roles; performance-enhancing strategies such as quality improvement or continuing education strategies; promotion of teamwork; and changes to workflow. Of all policy options, the use of lay health workers had the greatest proportion of reviews in countries with a range of incomes, from high to low. We have identified a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries.
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                Author and article information

                Contributors
                mario.lopes@fe.up.pt
                almeida@fep.up.pt
                almada.lobo@fe.up.pt
                Journal
                Hum Resour Health
                Hum Resour Health
                Human Resources for Health
                BioMed Central (London )
                1478-4491
                24 May 2015
                24 May 2015
                2015
                : 13
                : 38
                Affiliations
                [ ]INESC TEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
                [ ]Faculdade de Economia, Universidade do Porto, Porto, Portugal
                Article
                28
                10.1186/s12960-015-0028-0
                4464124
                26003337
                8454fea0-e5aa-4220-b717-965972c2a71e
                © Amorim Lopes et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 November 2014
                : 2 May 2015
                Categories
                Review
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                review,health-care workforce planning,supply,demand,needs,health policy
                Health & Social care
                review, health-care workforce planning, supply, demand, needs, health policy

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