Health workforce governance in Italy |
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| Institution: | 1. DISES, Università Politecnica delle Marche, Piazzale Martelli, 8, 60100 Ancona (AN), Italy;2. SPOCRI, Macerata University, Via Don Minzoni, 2, 62100, Macerata (MC), Italy;1. NIVEL – Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands;2. Utrecht University, Department of Human Geography, Utrecht, The Netherlands;3. Utrecht University, Department of Sociology, Utrecht, The Netherlands;4. Hochschule Fulda – University of Applied Sciences, Department of Health Sciences, Leipziger Straße 123, 36037 Fulda, Germany;1. Northern Institute, Charles Darwin University, Darwin, Australia;2. Glesbygdsmedicinskt Centrum, Storuman, Sweden;3. Arctic Research Centre at Umeå University, Umeå, Sweden;4. Flinders University Rural Clinical School, Renmark, Australia;1. Department of Public Health and Primary Care, Catholic University Leuven, Kapucijnenvoer 35 blok d—bus 7001, 3000 Leuven, Belgium;2. International Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, Global Health & Tropical Medicine Centre (GHTM), WHO Collaborating Centre for Health Workforce Policy and Planning, New University of Lisbon, Rua da Junqueira 100, 1349-008 Lisbon, Portugal;3. Royal Tropical Institute, PO Box 95001, 1090 HA Amsterdam, The Netherlands;4. Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology, 235–253 Jones Street, Ultimo NSW 2007, Sydney, NSW, Australia;5. School of Health, Queen Margaret University, Musselburgh EH21 6UU, Edinburgh, United Kingdom;6. Florence Nightingale Faculty of Nursing and Midwifery, King''s College, 57 Waterloo Road, London SE1 8WA, United Kingdom;7. European Health Management Association, Rue Belliard 15-17, 1040 Brussels, Belgium;1. School of Public Health, Faculty of Medicine, University Vita-Salute San Raffaele, Milan, Italy;2. Department of Medicine and Surgery, University of Parma, Italy;3. Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy |
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| Abstract: | More precise health workforce governance has become a prominent issue in healthcare systems. This issue is particularly important in Italy, given its strongly doctor-centered healthcare system and the dramatic aging of its physicians’ labor force. Using different sources of information (statistical data, official planning documents and interviews with key informants), the article attempts to answer two questions. Why has the Italian healthcare systems found itself in the situation of a potential drastic reduction in the amount of doctors in the medium term without a rebalancing through a different mix of skills and professionals? How good is the capacity of the Italian healthcare system to plan healthcare workforce needs? The widespread presence of ‘older’ physicians is the result of the strong entry of doctors into the Italian healthcare system in the 1970s and 1980s. Institutional fragmentation, difficulties in drafting broad healthcare reforms, political instability and austerity measures explain why Italian health workforce forecasting and planning are still unsatisfactory, although recent developments indicate that changes are under way. In order to tackle these problems it is necessary to foster closer cooperation among a wide range of stakeholders, to move from uni-professional to multi-professional health workforce planning, and to partially re-centralise decision making. |
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| Keywords: | Health workforce planning Health workforce governance Health professionals Physicians Italy Aging medical workforce |
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