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Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe

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dc.contributor.author de Bont, Antoinette
dc.contributor.author van Exel, Job
dc.contributor.author Coretti, Silvia
dc.contributor.author Ökem, Zeynep Güldem
dc.contributor.author Janssen, Maarten
dc.contributor.author Hope, Kristin Lofthus
dc.contributor.author Ludwicki, Tomasz
dc.contributor.author Zander, Britta
dc.contributor.author Zvonickova, Marie
dc.contributor.author Bond, Christine
dc.contributor.author Wallenburg, Iris
dc.date.accessioned 2019-07-03T14:45:49Z
dc.date.available 2019-07-03T14:45:49Z
dc.date.issued 2016
dc.identifier.citation de Bont, A., van Exel, J., Coretti, S., Ökem, Z. G., Janssen, M., Hope, K. L., ... & Wallenburg, I. (2016). Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe. BMC health services research, 16(1), 637. en_US
dc.identifier.issn 1472-6963
dc.identifier.uri https://doi.org/10.1186/s12913-016-1898-0
dc.identifier.uri http://hdl.handle.net/20.500.11851/1619
dc.description.abstract Background: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change. The research questions guiding this study were: What extended professional roles are emerging on health care teams? How are extended professional roles created? What main drivers explain the observed differences, if any, in extended roles in and between countries? Methods: We performed a case-based comparison of the extended roles in care pathways for breast cancer, heart disease and type 2 diabetes. We conducted 16 case studies in eight European countries, including in total 160 interviews with physicians, nurses and other health care professionals in new roles and 600+ hours of observation in health care clinics. Results: The results show a relatively diverse composition of roles in the three care pathways. We identified specialised roles for physicians, extended roles for nurses and technicians, and independent roles for advanced nurse practitioners and physician associates. The development of extended roles depends upon the willingness of physicians to delegate tasks, developments in medical technology and service (re) design. Academic training and setting a formal scope of practice for new roles have less impact upon the development of new roles. While specialised roles focus particularly on a well-specified technical or clinical domain, the generic roles concentrate on organising and integrating care and cure. Conclusion: There are considerable differences in the number and kind of extended roles between both countries and care pathways. The main drivers for new roles reside in the technological development of medical treatment and the need for more generic competencies. Extended roles develop in two directions: 1) specialised roles and 2) generic roles. en_US
dc.language.iso eng en_US
dc.publisher BMC en_US
dc.rights info:eu-repo/semantics/openAccess
dc.subject Skill mix en_US
dc.subject Health workforce en_US
dc.subject Europe en_US
dc.subject Extended roles en_US
dc.subject Advanced roles en_US
dc.subject Comparative study en_US
dc.subject Health care teams en_US
dc.title Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe en_US
dc.type article en_US
dc.relation.journal Bmc Health Services Research en_US
dc.contributor.department TOBB ETU, Faculty of Economics and Administrative Sciences, International Entrepreneurship en_US
dc.contributor.department TOBB ETÜ, İktisadi ve İdari Bilimler Fakültesi, Uluslararası Girişimcilik Bölümü tr_TR
dc.identifier.volume 16
dc.identifier.wos WOS:000387278100003
dc.identifier.scopus 2-s2.0-84994683551
dc.contributor.tobbetuauthor Ökem, Zeynep Güldem
dc.contributor.YOKid 192696
dc.identifier.PubMedID PMID:27825345
dc.identifier.doi 10.1186/s12913-016-1898-0
dc.contributor.ScopusAuthorID 56798593300
dc.relation.publicationcategory Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı tr_TR
dc.relation.international Chief Scientist Office [HERU1] en_US


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