Well-trained, well distributed and productive health workers are crucial for ensuring access to high quality and cost-effective health care in OECD countries.
With a large share of expenditure going into wages and remuneration of health professionals, countries must make sure they do not train too many health workers because this would waste costly training capacity and potentially contribute to problems of induced demand. But they also have to avoid training too few health professionals because this could lead to problems of access and potential cost increases due to delayed treatment.
At the same time, the increasingly integrated labour market for health professionals means that countries less and less exert control over the number of health professionals working in their systems. Health workforce policy needs to adapt to this changing environment, while an ageing society will likely lead to growing and more complex demand for healthcare services.
However, many countries face tight fiscal constraints following the economic crisis. For the immediate future, the slowdown in health expenditure means that “Doing more with less” is now imperative for healthcare delivery across OECD countries. This has shifted policy priorities from concerns about widespread shortages of health workers to more nuanced concerns about allocation and utilisation of health professionals.
The work of the OECD examines trends and priorities in health workforce policy in OECD countries. Current projects analyse different aspects of health workforce policy, including how countries can improve their health workforce planning, what policymakers can do to ensure that doctors practice where they are most needed, and whether health workers put their skills to effective use in their jobs. In addition, a data collection effort is underway to document and analyse recent trends in health worker migration.
Contact: Michael Schoenstein, firstname.lastname@example.org.
Health Workforce Planning
- Health Workforce Planning in OECD Countries: A Review of 26 Projection Models from 18 Countries, Working Paper No. 62 (June 2013). Tomoko Ono, Gaetan Lafortune, Michael Schoenstein.
Health workforce planning aims to achieve a proper balance between the supply and demand for different categories of health workers, in both the short and longer-term. Workforce planning in the health sector is particularly important, given the time and cost involved in training new doctors and other health professionals. In a context of tight budget constraints, proper health workforce planning is needed not only to guide policy decisions on entry into medical and nursing education programmes, but also to assess the impact of possible re-organisations in health service delivery to better respond to changing health care needs.
Geographic imbalances in doctor supply
- Geographic Imbalances in Doctor Supply and Policy Responses, Working Paper No. 69 (April 2014). Tomoko Ono, Michael Schoenstein, James Buchan.
Doctors are distributed unequally across different regions in virtually all OECD countries, and this causes concern about how to continue to ensure access to health services everywhere. In particular access to services in rural regions is the focus of attention of policymakers, although in some countries, poor urban and sub-urban regions pose a challenge as well. Despite numerous efforts this mal-distribution of physician supply persists. This working paper first examines the drivers of the location choice of physicians, and second, it examines policy responses in a number of OECD countries.
Other Working Papers:
- The Impact of Pay Increases on Nurses' Labour Market: A Review of Evidence from Four OECD Countries, Working Paper No. 57 (August 2011). James Buchan and Steven Black.
- Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries, Working Paper No. 54 (July 2010). Marie-Laure Delamaire and Gaetan Lafortune.
Also available in French: Les Pratiques Infirmières Avancées : Une Description et Évaluation des Expériences dans 12 Pays Développés.
Health Workforce chapter in Health at a Glance 2013 - OECD Indicators:
Former projects on health workforce and migration
Click on the cover for a free preview
Publication date: October 2008
The looming crisis in the health workforce: How can OECD countries respond?
Introduction | Table of contents | How to obtain this publication
OECD countries face a challenge in responding to the growing demand for doctors and nurses over the next 20 years. This challenge arises in a world which is already characterised by significant international migration of health workers, both across OECD countries and between some developing countries and the OECD area.
What combination of human-resource management policies and migration policies is adopted by OECD countries? How do migration and other health workforce policies interact with each other? How can destination countries build a sustainable health workforce? What are the consequences of emigration of doctors and nurses for origin countries?
The detailed statistics, tables and charts contained in the report are available via the StatLinks printed in the book.
International Migration Outlook
Special chapter: Immigrant Health Workers in OECD Countries in the Broader Context of Highly Skilled Migration
This chapter presents a comprehensive and relevant picture of immigrants in the health sector in OECD countries, in order to better inform the policy dialogue at national and international levels. Section one refers to different sources of data to qualify the nature and the scope of international migration of doctors and nurses in OECD countries and deals with the main issues at stake for origin countries. Section two provides an evaluation of the most recent trends and section three reviews migration policies of OECD member countries related to health professionals. The conclusion summarises the main findings and identifies the opportunities and challenges for origin and receiving countries.
WHO-OECD hosted dialogue on migration and other health workforce issues in a global economy
Geneva, 20-21 October 2008
The World Health Organization (WHO) and the Organization for Economic Development (OECD) collaborated in the organization of the conference, "WHO-OECD Hosted Dialogue on Migration and other Health Workforce issues in a Global Economy". The core objectives of this conference are:
to identify priority areas for future research at international level;
to strengthen international collaboration on international health worker migration, including the establishment of mechanisms for monitoring flows and stocks of health professional migrants;
to stimulate actions in participating countries along the lines of the options discussed during the Dialogue.
Dedicated WHO website
Health Workforce and Migration Data
OECD studies on health workforce
Other OECD ongoing projects related to health workforce
Long term care workforce and international migration. A recently published OECD report analyses the growing demand for human resources in the long-term care sector. Drawing from selected OECD countries’ experience, the study provides an overview of the long-term care workforce policies to build adequate human resources for the provision of long-term care - including improving retention, training and international recruitment. It also discusses challenges to address workforce shortages.
How to obtain the publication "The Looming Crisis in the Health Workforce"
Readers can access the full version via the following options:
A Profile of Immigrant Populations in the 21st Century: Data from OECD Countries