scholarly journals Time Trends in the Regional Distribution of Physicians, Nurses and Midwives in Europe

2020 ◽  
Author(s):  
Juliane Winkelmann ◽  
Ulrike Muench ◽  
Claudia B. Maier
Keyword(s):  
Health Professionals ◽  
Time Trends ◽  
Regional Distribution ◽  
European Countries ◽  
Annual Growth Rate ◽  
Physician Density ◽  
Cross Country ◽  
Nurses And Midwives ◽  
Over Time ◽  
Distribution Of Physicians

Abstract Background. Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions and examine time trends.Methods. We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005-2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 15 European countries being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR).Results. There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variation and varied up to 4.5-fold both for physicians and nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tends to be higher in more sparsely populated areas. Conclusions. The large variation in workforce supply at regional levels highlights the importance for countries to routinely collect data at sub-national geographic areas in order for workforce planners, employers, educators and others to develop policies and initiatives that may impact supply of health professionals at regional levels.

scholarly journals Time trends in the regional distribution of physicians, nurses and midwives in Europe

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juliane Winkelmann ◽  
Ulrike Muench ◽  
Claudia B. Maier
Keyword(s):  
Health Workforce ◽  
Health Professionals ◽  
Time Trends ◽  
Regional Distribution ◽  
Annual Growth Rate ◽  
Physician Density ◽  
Cross Country ◽  
Nurses And Midwives ◽  
Over Time ◽  
Distribution Of Physicians

Abstract Background Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions in Europe and examine time trends. Methods We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005–2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 14 European Union (EU) countries and Switzerland being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR). Results There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria national average: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variations and varied up to 5.5-fold for physicians and 4.4-fold for nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tended to be higher in more sparsely populated areas. Over time, physician rates increased faster than density levels of nurses and midwives. Conclusions The study shows for the first time the large variation in health workforce supply at regional levels and time trends by professions across the European region. This highlights the importance for countries to routinely collect data in sub-national geographic areas to develop integrated health workforce policies for health professionals at regional levels.

scholarly journals Time trends in the regional distribution of physicians, nurses and midwives in Europe

2020 ◽  
Author(s):  
Juliane Winkelmann ◽  
Ulrike Muench ◽  
Claudia B. Maier
Keyword(s):  
Health Workforce ◽  
Health Professionals ◽  
Time Trends ◽  
Regional Distribution ◽  
Annual Growth Rate ◽  
Physician Density ◽  
Cross Country ◽  
Nurses And Midwives ◽  
Over Time ◽  
Distribution Of Physicians

Abstract Background. Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions in Europe and examine time trends.Methods. We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005-2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 145 European Union (EU) countries and Switzerland being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR).Results. There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria national average: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variations and varied up to 5.5-fold for physicians and 4.5-fold for nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tendeds to be higher in more sparsely populated areas. Over time, physician rates increased faster than density levels of nurses and midwives.Conclusions. The study shows for the first time theThe large variation in health workforce supply at regional levels and time trends by professions across the European region. This highlights the importance for countries to routinely collect data at in sub-national geographic areas in order for workforce planners, employers, educators and others to develop integrated health workforce policies and initiatives that may impact supply offor health professionals at regional levels.

scholarly journals Time trends in the regional distribution of physicians, nurses and midwives in Europe

2020 ◽  
Author(s):  
Juliane Winkelmann ◽  
Ulrike Muench ◽  
Claudia B. Maier
Keyword(s):  
Health Workforce ◽  
Health Professionals ◽  
Time Trends ◽  
Regional Distribution ◽  
Annual Growth Rate ◽  
Physician Density ◽  
Cross Country ◽  
Nurses And Midwives ◽  
Over Time ◽  
Distribution Of Physicians

Abstract Background. Country-level data suggest large differences in the supply of health professionals among European countries. However, little is know about the regional supply of health professionals taking a cross-country comparative perspective. The aim of the study was to analyse the regional distribution of physicians, nurses and midwives in the highest and lowest density regions in Europe and examine time trends.Methods. We used Eurostat data and descriptive statistics to assess the density of physicians, nurses and midwives at national and regional levels (Nomenclature of Territorial Units for Statistics (NUTS) 2 regions) for 2017 and time trends (2005-2017). To ensure cross-country comparability we applied a set of criteria (working status, availability over time, geographic availability, source). This resulted in 14 European Union (EU) countries and Switzerland being available for the physician analysis and eight countries for the nurses and midwives analysis. Density rates per population were analysed at national and NUTS 2 level, of which regions with the highest and lowest density of physicians, nurses and midwives were identified. We examined changes over time in regional distributions, using percentage change and Compound Annual Growth Rate (CAGR).Results. There was a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria national average: 513, Poland 241.6 per 100,000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483.0). Differences by regions across Europe were higher than cross-country variations and varied up to 5.5-fold for physicians and 4.4-fold for nurses/midwives and did not improve over time. Capitals and/or major cities in all countries showed a markedly higher supply of physicians than more sparsely populated regions while the density of nurses and midwives tended to be higher in more sparsely populated areas. Over time, physician rates increased faster than density levels of nurses and midwives.Conclusions. The study shows for the first time the large variation in health workforce supply at regional levels and time trends by professions across the European region. This highlights the importance for countries to routinely collect data in sub-national geographic areas to develop integrated health workforce policies for health professionals at regional levels.

scholarly journals Time trends in the geographical distribution of physicians, nurses and midwives in Europe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Winkelmann ◽  
C B Maier
Keyword(s):  
Geographical Distribution ◽  
Health Professionals ◽  
Time Trends ◽  
National Level ◽  
Regional Level ◽  
European Countries ◽  
Physician Density ◽  
Cross Country ◽  
Nurses And Midwives ◽  
Over Time

Abstract Background Data on the supply of health professionals show large variations in the health workforce density among European countries based on national-level data. However, little attention has been paid to the comparison of health professional density at the regional level. This study aimed to analyse the density of physicians, nurses and midwives at regional level, using a cross-country comparative design and examine time trends. Methods Descriptive analysis of Eurostat data on the rate of health professionals per population at national and regional levels (NUTS 2 regions) for 2017 and time trends (2005-2017) and comparison to population density. To improve the cross-country comparability of data a set of criteria was applied, resulting in 15 European countries covered on physicians and eight for nurses and midwives. Changes over time in the regional distribution were analysed, using percentage change and compound annual growth rate (CAGR). Results We found a 2.4-fold difference in the physician density between the highest and lowest density countries (Austria: 513, Poland 241.6 per 100.000) and a 3.5-fold difference among nurses (Denmark: 1702.5, Bulgaria: 483). Differences by regions across Europe were higher and varied up to 4.5-fold both for physicians and nurses/midwives and did not improve over time. Results show that in all countries physician density levels are highest in densely populated regions, with capitals and/or major cities, while density of nurses and midwives tends to be higher in less populated areas. Overall, physician rates grew at a faster rate than the density levels of nurses and midwives. Conclusions International data should not only cover supply indicators at national level, but routinely collect regional data on the number of health professionals to demonstrate regional differences in workforce supply and to improve monitoring and workforce planning at regional levels. Key messages Despite increases in the density levels of physicians, nurses and midwives, time trends over a ten-year period showed no improvement in the geographical distribution within countries. The study is the first of its kind to descriptively analyse geographical density levels and time trends among health professionals across a selection of European countries using Eurostat data.

Introduction

2018 ◽  
Author(s):  
Telesca Giuseppe
Keyword(s):  
Structural Analysis ◽  
Institutional Change ◽  
Cultural Context ◽  
The Past ◽  
Final Goal ◽  
Social Structural ◽  
Country Analysis ◽  
Cross Country ◽  
Over Time

The ambition of this book is to combine different bodies of scholarship that in the past have been interested in (1) providing social/structural analysis of financial elites, (2) measuring their influence, or (3) exploring their degree of persistence/circulation. The final goal of the volume is to investigate the adjustment of financial elites to institutional change, and to assess financial elites’ contribution to institutional change. To reach this goal, the nine chapters of the book introduced here look at financial elites’ role in different European societies and markets over time, and provide historical comparisons and country and cross-country analysis of their adaptation and contribution to the transformation of the national and international regulatory/cultural context in the wake of a crisis or in a longer term perspective.

scholarly journals Did Lockdown Work? An Economist’s Cross-Country Comparison

2021 ◽  
Author(s):  
Christian Bjørnskov
Keyword(s):  
Mortality Rates ◽  
European Countries ◽  
Country Comparison ◽  
Clear Association ◽  
Policy Measures ◽  
Two Indices ◽  
Cross Country

Abstract I explore the association between the severity of lockdown policies in the first half of 2020 and mortality rates. Using two indices from the Blavatnik Centre’s COVID-19 policy measures and comparing weekly mortality rates from 24 European countries in the first halves of 2017–2020, addressing policy endogeneity in two different ways, and taking timing into account, I find no clear association between lockdown policies and mortality development.

scholarly journals Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008–2016: a repeated cross-sectional study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Minoru Takakura ◽  
Masaya Miyagi ◽  
Akira Kyan
Keyword(s):  
Time Trends ◽  
Parental Education ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
School Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Adolescents ◽  
Index Of Inequality ◽  
Over Time

Abstract Background Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016. Methods We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated. Results Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time. Conclusions Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.

scholarly journals Biomarker testing and mutation prevalence in metastatic colorectal cancer patients in five European countries using a large oncology database

2021 ◽  
Author(s):  
George Kafatos ◽  
Victoria Banks ◽  
Peter Burdon ◽  
David Neasham ◽  
Caroline Anger ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Braf Mutation ◽  
European Countries ◽  
High Prevalence ◽  
Biomarker Testing ◽  
Colorectal Cancer Patients ◽  
Over Time

Background: The literature on biomarker testing for metastatic colorectal cancer (mCRC) in Europe is scarce. This study aimed to estimate the percentage of mCRC patients from five European countries tested for biomarkers over time. Materials & methods: An oncology database was retrospectively analyzed; evaluated biomarkers were RAS, BRAF and microsatellite instability (MSI). The patients were drug treated during 2018 and tested for relevant biomarkers in 2013–2018. Results: RAS testing was conducted in >90% of mCRC patients from 2014 onwards. BRAF testing increased from 31% of mCRC patients in 2013 to 67% in 2018. MSI testing increased from 10 to 41%. There was no notable trend over time for RAS and BRAF mutation or MSI-high prevalence. Conclusion: Biomarker testing among patients diagnosed with mCRC was increased over time. This study demonstrates the quick uptake of biomarker testing in clinical practice. These findings are significant as biomarker-based drugs are becoming more common.

scholarly journals Variation in the prices of oncology medicines across Europe and the implications for the future

2021 ◽  
Vol 10 (2) ◽  
pp. 72-82
Author(s):  
Brian Godman ◽  
Steven Simoens ◽  
Amanj Kurdi ◽  
Gisbert Selke ◽  
John Yfantopoulos ◽  
...  
Keyword(s):  
Population Size ◽  
Patent Protection ◽  
Lower Cost ◽  
European Countries ◽  
Health Authorities ◽  
Before And After ◽  
Per Capita ◽  
Oral Oncology ◽  
Over Time ◽  
Ageing Populations

Introduction/Objectives: Health authorities are facing increasing challenges to the sustainability of their healthcare systems because of the growing expenditures on medicines, including new, high-priced oncology medicines, and changes in disease prevalence in their ageing populations. Medicine prices in European countries are greatly affected by the ability to negotiate reasonable prices. Concerns have been expressed that prices of patented medicines do not fall sufficiently after the introduction of lower-cost generic oncology medicines. The objective of this study was to examine the associations over time in selected European countries between the prices of oral oncology medicines, population size, and gross domestic product (GDP) before and after the introduction of generic versions. Evidence of periodic reassessments of the price, value, and place in treatment of these medicines was also looked for. The goal of this review was to stimulate debate about possible improvements in approaches to reimbursement negotiations. Methodology: Analysis was performed of reimbursed prices of three oral oncology medicines (imatinib, erlotinib and fludarabine) between 2013 and 2017 across Europe. Correlations were explored between GDP, population size, and prices. Findings were compared with previous research regarding prices of generic oral oncology medicines. Results: The prices of imatinib, erlotinib and fludarabine varied among European countries, and there was limited price erosion over time in the absence of generics. There appeared to be no correlation between population size and price, but higher prices of on-patent oral cancer medicines were seen among countries with higher GDP per capita. Conclusion: Limited price erosion for patented medicines contributed to increases in oncology medicine budgets across the region. There was also a concerning lack of evidence re-assessments of the price, value, and place in treatment of patented oncology medicines following the loss of patent protection of standard medicines. The use of such proactive re-assessments in negotiating tactics might positively impact global expenditures for oncology medicines.

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