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14. HUMAN RESOURCES IN HEALTH
Principles and analytical use
A number of national and international data sets contain information on health workers or human resources in health. However, coverage varies across data sets, across countries and over a time. Frequently classifications used, concepts, definitions and methodologies applied are not harmonized and collection systems differ. Furthermore data sets are created for a specific purpose or use and display different structures and use different analytical and measurement units, all of which explains the need of a common framework of the Health Labour Accounts (HLA).
The issues relevant for human resources development within the health area in the context of HLA are among others
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migration of health professions,
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human capital formation, and
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productivity measurement.
The migration of health professions between Member States and between Member States and the rest of the world, as well as changes in current and future requirements for human resources in health are of particular interest in view of shortages of some health professions.
Education and training is an important dimension of the analysis of inflows to labour market and the qualifications of health professions. Finally, labour productivity is a key economic indicator for the analysis of economic growth, planning for human resources in health, and efficiency.
Two different angles of approach are possible in discussing the human resources in health (care). One approach starts in the professions which are seen of primary importance to health in whichever branch these occupations are employed. Another approach is starting in the economic units or providers of health and strives to determine all human resources included in the health branch, whichever occupation is carried out. Both approaches are policy relevant. The first approach is necessary to be able to decide on the surpluses and shortages of certain professions/occupations. The second one is necessary for the determination of efficiency and efficacy of the services provided. This approach should be then treated as an ultimate goal as the information on the salaries (of employees and self-employed persons) is important, especially for establishing the link between SHA and HLA in monetary terms.
Key Issues
Any useful link of health care human resources data to health accounts requires comparability of the production boundary and of the breakdown to production units. The international classification of providers ICHA-HP in the framework of SHA offers the link between the output produced by health care providers and the input of human resources in the production process. However due to both the lack of information sources and its diversity, certain aspects of HLA methodology have to be carefully tackled:
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production units (ICHA-HP)
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the choice in manpower measurement units (the hours worked, FTE, jobs, head count as well as e.g. the. full-time/part-time workers split
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occupation (ISCO vs. national classification including health and non health professions)
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education (ISCED vs. national classification)
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