Characteristics of medical deserts and approaches to mitigate their health work-force issues : A scoping review of empirical studies in Western countries
Flinterman, Linda E.; González-González, Ana I.; Seils, Laura; Bes, Julia; Ballester, Marta; Bañeres, Joaquim; Dan, Sorin; Domagała, Alicja; Dubas-Jakóbczyk, Katarzyna; Likic, Robert; Kroezen, Marieke; Batenburg, Ronald (2023-06-03)
Flinterman, Linda E.
González-González, Ana I.
Seils, Laura
Bes, Julia
Ballester, Marta
Bañeres, Joaquim
Dan, Sorin
Domagała, Alicja
Dubas-Jakóbczyk, Katarzyna
Likic, Robert
Kroezen, Marieke
Batenburg, Ronald
Kerman University of Medical Sciences
03.06.2023
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi-fe20230829112610
https://urn.fi/URN:NBN:fi-fe20230829112610
Kuvaus
vertaisarvioitu
©2023 Authors. Published by Kerman University of Medical Sciences. Reusing and publishing IJHPM published articles (main text, tables, and figures) is permitted by following Creative Commons user license: https://creativecommons.org/licenses/by/4.0/.
©2023 Authors. Published by Kerman University of Medical Sciences. Reusing and publishing IJHPM published articles (main text, tables, and figures) is permitted by following Creative Commons user license: https://creativecommons.org/licenses/by/4.0/.
Tiivistelmä
Background
Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project “ROUTE-HWF” (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies).
Methods
We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes.
Results
Two-hundred and forty studies were included (n = 116, 48% Australia/New Zealand; n = 105, 44% North America; n = 20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n = 171, 71%), characteristics (n = 95, 40%), contributing factors (n = 112, 47%), and approaches to mitigate medical deserts (n = 87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n = 55, 23%) and lifestyle-related factors (n = 33, 14%) of the HWF as well as sociodemographic characteristics (n = 79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n = 67, 28%), HWF distribution (n = 3, 1%), support/infrastructure (n = 8, 3%) and innovative models of care (n = 7, 3%).
Conclusion
Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues.
Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project “ROUTE-HWF” (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies).
Methods
We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes.
Results
Two-hundred and forty studies were included (n = 116, 48% Australia/New Zealand; n = 105, 44% North America; n = 20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n = 171, 71%), characteristics (n = 95, 40%), contributing factors (n = 112, 47%), and approaches to mitigate medical deserts (n = 87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n = 55, 23%) and lifestyle-related factors (n = 33, 14%) of the HWF as well as sociodemographic characteristics (n = 79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n = 67, 28%), HWF distribution (n = 3, 1%), support/infrastructure (n = 8, 3%) and innovative models of care (n = 7, 3%).
Conclusion
Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues.
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