1932
0
  1. Home
  2. A-Z Publications
  3. Annual Review of Public Health
  4. Volume 35, 2014
  5. Article

Annual Review of Public Health

Volume 35, 2014

Scale, Causes, and Implications of the Primary Care Nursing Shortage

Abstract

As the demand for health care consistently rises and many individuals, even within developed countries, lack access to primary care services, a better understanding of how primary care is defined, the main causes of the primary care shortage both within the United States and across the globe, and key solutions to these issues are paramount. Upon review of the US and international primary care literature, the authors first briefly discuss the fluidity of how primary care is defined and how it is applied in nations with differing levels of health care infrastructure. The main causes of the deficit both domestically and globally are then examined. Finally, upon careful review of the research produced within the past seven years, this article suggests strategies that maximize the primary care workforce: the effective use of technology, task shifting, interprofessional teams, and more consistent primary care data to build workforce strategies.

Keyword(s): global nursing workforce, primary care providers, provider shortage, solutions, workforce
Loading

Article metrics loading...

/content/journals/10.1146/annurev-publhealth-032013-182508
2014-03-18
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/publhealth/35/1/annurev-publhealth-032013-182508.html?itemId=/content/journals/10.1146/annurev-publhealth-032013-182508&mimeType=html&fmt=ahah

Literature Cited

  1. Adkoli BV. 1.  2006. Migration of health workers: perspectives from Bangladesh, India, Nepal, Pakistan and Sri Lanka. Reg. Health Forum 10:149–58 [Google Scholar]
  2. 2. Agency Healthc. Res. Quality 2011. The Number of Nurse Practitioners and Physician Assistants Practicing Primary Care in the United States. Rockville, MD: US Dep. Health Hum. Serv http://www.ahrq.gov/research/findings/factsheets/primary/pcwork2/index.html
  3. 3. Am. Assoc. Coll. Nurs. (AACN) 2012. Nursing Faculty Shortage Washington, DC: AACN http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-faculty-shortage
  4. Bangdiwala SI, Fonn S, Okoye O, Tollman S. 4.  2010. Workforce resources for health in developing countries. Public Health Rev. 32:1296–318 [Google Scholar]
  5. Birkeland AL, Hägglöf B, Dahlgren L, Rydberg A. 5.  2013. Interprofessional teamwork in Swedish pediatric cardiology: a national exploratory study. J. Interprof. Care. 27:320–25 [Google Scholar]
  6. Brown RP, Connell J. 6.  2004. The migration of doctors and nurses from South Pacific Island Nations. Soc. Sci. Med. 58:112193–210 [Google Scholar]
  7. Cassidy A. 7.  2012. Health policy brief: nursing practitioners and primary care. Health Aff Oct. 25. http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_79.pdf
  8. Cronenwett LR. 8.  2010. The future of nursing education. See Ref. 20 477–564
  9. Derksen DJ, Whelan E-M. 9.  2010. Closing the Health Care Workforce Gap: Reforming Federal Health Care Workforce Policies to Meet the Needs of the 21st Century Washington, DC: Cent. Am. Prog http://www.americanprogress.org/issues/healthcare/report/2010/01/15/7135/closing-the-health-care-workforce-gap/
  10. Dolan B. 10.  2013. WebMD, Medscape to take on app prescribing, discoverability. MobiHealthNews March 9. http://mobihealthnews.com/20655/webmd-medscape-to-take-on-app-prescribing-discoverability/
  11. Dovlo D. 11.  2007. Migration of nurses from Sub-Saharan Africa: a review of issues and challenges. Health Serv. Res. 42:3 Pt. 21373–88 [Google Scholar]
  12. 12. Every Mother Counts 2011. The Healthcare Worker Shortage Washington, DC: Every Mother Counts http://everymothercounts.org/sites/default/files/education/files/The-HR-Shortage-Study-Guide-MPH_0.pdf
  13. Fairman JA, Rowe JW, Hassmiller S, Shalala DE. 13.  2011. Broadening the scope of nursing practice. N. Engl. J. Med. 364:3193–96 [Google Scholar]
  14. Franko OI, Tirrell TF. 14.  2012. Smartphone app use among medical providers in ACGME training programs. J. Med. Syst. 36:53135–39 (Abstr.) [Google Scholar]
  15. Freed GL, Stockman JA. 15.  2009. Oversimplifying primary care supply and shortages. JAMA 301:181920–22 [Google Scholar]
  16. Goodell S, Dower C, O'Neil E. 16.  2011. Primary Care Workforce in the United States Synth. Proj. Policy Brief No. 22 Princeton, NJ: Robert Wood Johnson Found http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf70613
  17. Haour-Knipe M, Davies AA. 17.  2008. Return Migration of Nurses Philadelphia, PA: Int. Cent. Nurse Migr http://www.intlnursemigration.org/assets/pdfs/ReturnmigrationA4.pdf
  18. Hill J. 18.  2012. iDoctor Pro puts complete patient medical histories in doctors' pockets. Daily App Show June 25. http://dailyappshow.com/idoctor-pro-puts-complete-patient-medical-histories-in-doctors-pockets
  19. 19. Inst. Med. (IOM) 2010. Meeting the need for better data on the health care workforce. See Ref. 20 213–26
  20. 20. Inst. Med. (IOM) 2010. The Future of Nursing: Leading Change, Advancing Health Washington, DC: Natl. Acad. Press http://www.thefutureofnursing.org/sites/default/files/6%20Meeting%20the%20Need%20for%20Better%20Data%20on%20the%20Health%20Care%20Workforce%20%28213-226%29.pdf
  21. 21. Inst. Med. (IOM) 2013. Appendix D: Faculty development programs at various universities. See Ref. 23 109–13
  22. 22. Inst. Med. (IOM) 2013. Appendix E: Disruptive innovations. See Ref. 23 114–16
  23. 23. Inst. Med. (IOM) 2013. Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice—Workshop Summary Washington, DC: Natl. Acad. Press
  24. 24. Int. Telecommun. Union 2012. Introduction. Measuring the Information Society1–14 Geneva: Int. Telecommun. Union http://www.itu.int/en/ITU-D/Statistics/Documents/publications/mis2012/MIS2012_without_Annex_4.pdf [Google Scholar]
  25. Kinfu Y, Dal Poz MR, Mercer H, Evans DB. 25.  2009. The health worker shortage in Africa: Are enough physicians and nurses being trained?. Bull. World Health Organ. 87:225–30 [Google Scholar]
  26. Klaassen WC. 26.  2007. Obstacles to health care: a nurse's experience in Sudan. Urol. Nurs. 27:5391–400 [Google Scholar]
  27. Lakhan SE, Laird C. 27.  2009. Addressing the primary care physician shortage in an evolving medical workforce. Int. Arch. Med. 2:114 [Google Scholar]
  28. Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. 28.  2005. Substitution of doctors by nurses in primary care. Cochrane Database Syst. Rev.2CD001271
  29. Mills JE, Francis K, Birks M, Coyle M, Henderson S, Jones J. 29.  2010. Registered nurses as members of interprofessional primary health care teams in remote or isolated areas of Queensland: collaboration, communication and partnerships in practice. J. Interprof. Care 24:5587–96 [Google Scholar]
  30. Mitchell P, Wynia M, Golden R, McNellis B, Okun S. 30.  et al. 2012. Core Principles and Values of Effective Team-Based Health Care—Discussion Paper Washington, DC: Inst. Med https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf
  31. Moore AE, Nair K, Patterson C, White J, House S. 31.  et al. 2013. Physician and nurse perspectives of an interprofessional and integrated primary care-based program for seniors. J. Res. Interprof. Pract. Educ. 3:1103–21 [Google Scholar]
  32. 32. Natl. Conf. State Legis. (NCSL) 2011. Primary Care Workforce Washington, DC: NCSL http://www.ncsl.org/issues-research/health/primary-care-workforce.aspx
  33. Nichols BL, Davis CR, Richardson DR. 33.  2010. International models of nursing. See Ref. 20 565–642
  34. 34. Nurs. Midwifery Counc. (NMC) 2006. Statistical Analysis of the Register London: NMC http://www.nmc-uk.org/Documents/Statistical%20analysis%20of%20the%20register/NMC-Statistical-analysis-of-the-register-202006-202007.pdf
  35. 35. Nurs. Midwifery Counc. (NMC) 2011. Analysis of diversity data: 2011 London: NMC http://www.nmc-uk.org/About-us/Equality-and-diversity/Analysis-of-diversity-data-2011/
  36. O'Brien P, Gostin LO. 36.  2011. The global health worker shortage—causes. See Ref. 38 19–42
  37. O'Brien P, Gostin LO. 37.  2011. The global shortage of health workers. See Ref. 38 8–18
  38. O'Brien P, Gostin LO. 38.  2011. Health Worker Shortages and Global Justice New York: Milbank Meml. Fund http://www.milbank.org/uploads/documents/HealthWorkerShortagesfinal.pdf
  39. 39. OECD 2007. Immigrant health workers in OECD countries in the broader context of highly skilled migration. International Migration Outlook 2007161–228 Paris: OECD http://www.oecd.org/els/mig/41515701.pdf [Google Scholar]
  40. 40. OECD 2011. Health at a Glance 2011: OECD Indicators Paris: OECD http://www.oecd.org/health/health-systems/49105858.pdf
  41. Oliver MN. 41.  2010. Mapping primary care: putting our patients in context. J. Am. Board Fam. Med. 23:11–3 [Google Scholar]
  42. 42. PAHO, UNFPA, UNIFEM 2006. Gender, Health, and Development in the Americas Washington, DC: Pan Am. Health Organ. (PAHO) http://www.unfpa.org/webdav/site/global/shared/documents/publications/2006/genderbrochure_eng.pdf
  43. 43. PEPID 2013. PEPID Delivers Infobutton Solution: Provides Immediate Support for Meaningful Use 2 Certification Chicago: PEPID http://www.pepid.com/press/read_news.asp?Id=236
  44. Pittman P, Folsom A, Bass E, Leonhardy K. 44.  2007. U.S.-Based International Nurse Recruitment: Structure and Practices of a Burgeoning Industry. Washington, DC: AcademyHealth http://www.intlnursemigration.org/assets/pdfs/Report-on-Year-I.pdf
  45. Portio Res. 45.  2013. Free Mobile Factbook 2013 Chippenham, UK: Portio Res http://www.portioresearch.com/en/free-mobile-factbook.aspx
  46. 46. Regist. Nurses' Assoc. Ont. (RNAO) 2013. Interprofessional Team Work in Healthcare Toronto: RNAO http://rnao.ca/bpg/guidelines/interprofessional-team-work-healthcare
  47. 47. Robert Wood Johnson Found. (RWJF) 2012. Four Major Foundations Join Together To Advance Interprofessional Health Education to Improve Patient Care and Foster Team-Based Learning: Effort Expands Newly Proposed National Center for Interprofessional Education and Collaborative Practice Princeton, NJ: RWJF http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2012/06/four-major-foundations-join-together-to-advance-interprofessiona.html
  48. Shaffer FA, To Dutka JY-H. 48.  2012. Perspectives on credential evaluation: future trends and regulatory implications. J. Nurs. Regul. 3:126–31 [Google Scholar]
  49. Stilwell B, Diallo K, Zurn P, Vujicic M, Adams O, Dal Poz M. 49.  2004. Migration of health-care workers from developing countries: strategic approaches to its management. Bull. World Health Organ. 82:8595–600 [Google Scholar]
  50. 50. United Nations 2012. Needs analysis. Sudan: UN and Partners Work Plan 201227–34 Khartoum: OCHA Sudan http://reliefweb.int/sites/reliefweb.int/files/resources/Full_Report_3057.pdf [Google Scholar]
  51. Versel N. 51.  2013. Topol goes prime time with his message about smartphones, smart monitors. MobiHealthNews Jan. 25. http://mobihealthnews.com/20032/topol-goes-prime-time-with-his-message-about-smartphones-smart-monitors/
  52. 52. Vital Wave Consult 2009. Meeting health needs through a broad array of applications. mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World9–14 Washington, DC: UN Found.–Vodafone Found. Partnersh http://unpan1.un.org/intradoc/groups/public/documents/unpan/unpan037268.pdf [Google Scholar]
  53. 53. WebMD 2011. What we do for our users. WebMD http://www.webmd.com/about-webmd-policies/about-what-we-do-for-our-users
  54. 54. World Health Organ. (WHO) 1978. Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata Geneva: WHO http://whqlibdoc.who.int/publications/9241800011.pdf
  55. 55. World Health Organ. (WHO) 2006. Global Atlas of the Health Workforce Geneva: WHO http://apps.who.int/globalatlas/docs/HRH/HTML/SASA_Aug08.htm
  56. 56. World Health Organ. (WHO) 2007. Eastern Mediterranean Regional Health System Observatory Geneva: WHO http://gis.emro.who.int/HealthSystemObservatory/Profile/Forms/frmProfileSelectionByCountry.aspx
  57. 57. World Health Organ. (WHO) 2008. International Conference on Primary Health Care and Health Systems in Africa: Towards the Achievement of the Health Millennium Development Goals—Discussion Paper Geneva: WHO
  58. 58. World Health Organ. (WHO) 2008. International Conference on Primary Health Care and Health Systems in Africa: Towards the Achievement of the Health Millennium Development Goals—Summaries of Country Experiences on Primary Health Care Revitalization Geneva: WHO
  59. 59. World Health Organ. (WHO) 2008. PHC resources. Report on the Review of Primary Health Care in the African Region37–44 Brazzaville: WHO Reg. Off. Afr. [Google Scholar]
  60. 60. World Health Organ. (WHO) 2008. Task Shifting: Global Recommendations and Guidelines Geneva: WHO Press http://www.who.int/healthsystems/TTR-TaskShifting.pdf
  61. 61. World Health Organ. (WHO) 2010. Framework for Action on Interprofessional Education & Collaborative Practice Geneva: WHO Press http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf
  62. 62. World Health Organ. (WHO) 2010. Increasing Access to Health Workers in Remote and Rural Areas Through Improved Retention: Global Policy Recommendations Geneva: WHO Press http://whqlibdoc.who.int/publications/2010/9789241564014_eng.pdf
  63. 63. World Health Organ. (WHO) 2011. Increasing Access to Health Workers in Rural and Remote Areas Geneva: WHO Press http://whqlibdoc.who.int/publications/2011/9789241501514_eng.pdf
  64. 64. World Health Organ. (WHO) 2011. Transformative Scale Up of Health Professional Education: An Effort to Increase the Numbers of Health Professionals and to Strengthen Their Impact on Population Health. Geneva: WHO Press http://whqlibdoc.who.int/hq/2011/WHO_HSS_HRH_HEP2011.01_eng.pdf
  65. 65. World Health Organ. (WHO) 2012. World Health Statistics 2012 Geneva: WHO Press http://apps.who.int/iris/bitstream/10665/44844/1/9789241564441_eng.pdf
  66. 66. World Health Organ. (WHO) 2013. Primary Health Care Geneva: WHO http://www.who.int/topics/primary_health_care/en/
  67. 67. World Health Organ. (WHO), Reg. Off. Eur 2013. European Health for All Database (HFA-DB). Geneva: WHO http://data.euro.who.int/hfadb/ [Google Scholar]
  68. 68. World Health Organ. (WHO), West. Pac. Reg 2013. Countries and Areas. Geneva: WHO http://www.wpro.who.int/countries/en/
/content/journals/10.1146/annurev-publhealth-032013-182508
Loading
Scale, Causes, and Implications of the Primary Care Nursing Shortage
Annual Review of Public Health 35, 443 (2014); https://doi.org/10.1146/annurev-publhealth-032013-182508
/content/journals/10.1146/annurev-publhealth-032013-182508
/content/journals/10.1146/annurev-publhealth-032013-182508
Loading

Data & Media loading...

  • Article Type: Review Article

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error