Medical deserts and disparities in population health within the European Union

Laura Alexandra Seils, Ana Isabel Gonzalez, Katarzyna Dubas-Jakobczyk, Alicja Domagala, Robert Likic, Sorin-Adrian Dan, Linda Flinterman, Ronald Batenburg

Keywords: medica deserts; health disparities; health workers; quality in healthcare; health outcomes

Background:

Medical deserts are increasingly considered a problematic issue for many countries, which try to employ a multitude of policies, actions, and initiatives to achieve a better distribution of the health workforce (HWF).

Research questions:

To develop a roadmap out of medical deserts through initiatives and policies that support healthcare workers.

Method:

First, a scoping review and a qualitative survey in 33 European countries on definitions, characteristics and influencing factors of medical deserts along with approaches to mitigate them were conducted. Further, five national stakeholder workshops to discuss and evaluate the developed taxonomy took place. Six in-depth case studies to further assess the applicability and usability of the taxonomy are under development. Finally, a workshop with European experts to evaluate the feasibility and usability of the taxonomy and to discuss the best mix of policy responses and approaches to medical deserts will be conducted.

Results:

From the review four main themes of influencing factors evolved: i) Work-related factors, ii) Migration, iii) Lifestyle-related factors and iv) Socio-demographic factors. Identified approaches for mitigation can be summarised under five categories: i) Under- and ii) Postgraduate training, iii) Innovative models of care, iv) Monitoring and planning distribution of the HWF and v) Professional support and infrastructure. The current version of the taxonomy consists of six different types of medical deserts, each with at least one demand and one supply object: 1. Percentage population aged 65 and over; 2. Mobility of the people; 3. Economic resources; 4. Population-provider ratio; 5. Presence of healthcare services; 6. Distance/time to facilities. A further developed version of the taxonomy will be available in May 2023.

Conclusions:

The final guidelines and taxonomy are expected to reduce disparities in population health within the EU by ensuring timely access to high quality health care in all regions of the EU.

Points for discussion:

What is the relevance of medical deserts for Croatia?

What are the factors contributing to the development of medical deserts?

What measures could be used to mitigate the problem of medical deserts?