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Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?

which countries include nurse practitioners and physician assistants and to what effect?
Authors: Maier, Claudia Bettina; Batenburg, Ronald; Birch, Stephen; Zander, Britta; Elliott, Robert; Busse, Reinhard;

Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?

Abstract

An increasing number of countries are introducing new health professions, such as Nurse Practitioners (NPs) and Physician Assistants (PAs). There is however limited evidence, on whether these new professions are included in countries' workforce planning.A cross-country comparison of workforce planning methods. Countries with NPs and/or PAs were identified, workforce planning projections reviewed and differences in outcomes were analysed, based on a review of workforce planning models and a scoping review. Data on multi-professional (physicians/NPs/PAs) vs. physician-only models were extracted and compared descriptively. Analysis of policy implications was based on policy documents and grey literature.Of eight countries with NPs/PAs, three (Canada, the Netherlands, United States) included these professions in their workforce planning. In Canada, NPs were partially included in Ontario's needs-based projection, yet only as one parameter to enhance efficiency. In the United States and the Netherlands, NPs/PAs were covered as one of several scenarios. Compared with physician-only models, multi-professional models resulted in lower physician manpower projections, primarily in primary care. A weakness of the multi-professional models was the accuracy of data on substitution. Impacts on policy were limited, except for the Netherlands.Few countries have integrated NPs/PAs into workforce planning. Yet, those with multi-professional models reveal considerable differences in projected workforce outcomes. Countries should develop several scenarios with and without NPs/PAs to inform policy.

Keywords

Canada, 330, Nurse Practitioner, 610, Health Services Needs and Demand/standards, R Medicine (General), Nurse practitioner, Inequality, cohesion and modernization, SDG 3 - Good Health and Well-being, Skill-mix, Physicians, substitution, Physician Assistants/supply & distribution, Humans, Nurse Practitioners, Ongelijkheid, cohesie en modernisering, Health Workforce, Human resources for health (HRH), European Commission, Physician Assistant, Netherlands, 360, Health Services Needs and Demand, Workforce planning, Physicians/supply & distribution, Health Policy, skill-mix, Health Workforce/organization & administration, 2719 Health Policy, Workforce projections, R1, United States, Physician assistant, HEALTH-F3-2012-305467EC, Health Planning, Physician Assistants, Nurse Practitioners/supply & distribution, Human Resources for Health (HRH), Substitution

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
33
Top 10%
Top 10%
Top 10%
bronze