The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?

Abstract Primary care services are key to population health and for the efficient and equitable organisation of national health systems. This is why they are often financed through public funds. Primary care doctors are instrumental for the delivery of preventive services, continuity of care, and fo...

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Main Authors: Giuliano Russo, Julian Perelman, Tomas Zapata, Milena Šantrić-Milićević
Format: Article
Language:English
Published: BMC 2023-07-01
Series:Human Resources for Health
Online Access:https://doi.org/10.1186/s12960-023-00842-4
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author Giuliano Russo
Julian Perelman
Tomas Zapata
Milena Šantrić-Milićević
author_facet Giuliano Russo
Julian Perelman
Tomas Zapata
Milena Šantrić-Milićević
author_sort Giuliano Russo
collection DOAJ
description Abstract Primary care services are key to population health and for the efficient and equitable organisation of national health systems. This is why they are often financed through public funds. Primary care doctors are instrumental for the delivery of preventive services, continuity of care, and for the referral of patients through the system. These cadres are also the single largest health expenditure at the core of such services. Although recruitment and retention of primary care doctors have always been challenging, shortages are now exacerbated by higher demand for services from aging populations, increased burden of chronic diseases, backlogs from the COVID-19 pandemic, and patient expectations. At the same time, the supply of primary care physicians is constrained by rising retirement rates, internal and external migration, worsening working conditions, budget cuts, and increased burnout. Misalignment between national education sectors and labour markets is becoming apparent, compounding staff shortages and maldistribution. With their predominantly publicly funded health systems and in the aftermath of COVID-19, countries of the European region appear to be now on the cusp of a multi-layered, slow-burning primary care crisis, with almost every country reporting long waiting lists for doctor appointments, shortages of physicians, unfilled vacancies, and consequently, added pressures on hospitals’ Accident and Emergency services. This articles collection aims at pulling together the evidence from countries of the European Region on root causes of such workforce crisis, impacts, and effectiveness of existing policies to mitigate it. Original research is needed, offering analysis and fresh insights into the primary care medical workforce crisis in wider Europe. Ultimately, the aim of this articles collection is to provide an evidence basis for the identification of policy solutions to present and future primary health care crises in high as well as lower-income countries.
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spelling doaj.art-a7c168b1d88f47088e357cd2e042159c2023-07-16T11:18:52ZengBMCHuman Resources for Health1478-44912023-07-012111410.1186/s12960-023-00842-4The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?Giuliano Russo0Julian Perelman1Tomas Zapata2Milena Šantrić-Milićević3Wolfson Institute of Population Health, Queen Mary University of LondonNova National School of Public Health and Comprehensive Health Research Center, Nova University of LisbonDivision of Country Health Policies and Systems, WHO Regional Office for EuropeFaculty of Medicine, School of Public Health and Health Management, Institute of Social Medicine, University of BelgradeAbstract Primary care services are key to population health and for the efficient and equitable organisation of national health systems. This is why they are often financed through public funds. Primary care doctors are instrumental for the delivery of preventive services, continuity of care, and for the referral of patients through the system. These cadres are also the single largest health expenditure at the core of such services. Although recruitment and retention of primary care doctors have always been challenging, shortages are now exacerbated by higher demand for services from aging populations, increased burden of chronic diseases, backlogs from the COVID-19 pandemic, and patient expectations. At the same time, the supply of primary care physicians is constrained by rising retirement rates, internal and external migration, worsening working conditions, budget cuts, and increased burnout. Misalignment between national education sectors and labour markets is becoming apparent, compounding staff shortages and maldistribution. With their predominantly publicly funded health systems and in the aftermath of COVID-19, countries of the European region appear to be now on the cusp of a multi-layered, slow-burning primary care crisis, with almost every country reporting long waiting lists for doctor appointments, shortages of physicians, unfilled vacancies, and consequently, added pressures on hospitals’ Accident and Emergency services. This articles collection aims at pulling together the evidence from countries of the European Region on root causes of such workforce crisis, impacts, and effectiveness of existing policies to mitigate it. Original research is needed, offering analysis and fresh insights into the primary care medical workforce crisis in wider Europe. Ultimately, the aim of this articles collection is to provide an evidence basis for the identification of policy solutions to present and future primary health care crises in high as well as lower-income countries.https://doi.org/10.1186/s12960-023-00842-4
spellingShingle Giuliano Russo
Julian Perelman
Tomas Zapata
Milena Šantrić-Milićević
The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
Human Resources for Health
title The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
title_full The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
title_fullStr The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
title_full_unstemmed The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
title_short The layered crisis of the primary care medical workforce in the European region: what evidence do we need to identify causes and solutions?
title_sort layered crisis of the primary care medical workforce in the european region what evidence do we need to identify causes and solutions
url https://doi.org/10.1186/s12960-023-00842-4
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