Review Gold Open Access 2023

Characteristics of Medical Deserts and Approaches to Mitigate Their Health Workforce Issues: A Scoping Review of Empirical Studies in Western Countries

International Journal of Health Policy and Management
Journal · Vol. 12 · Issue 1 · Art. 7454
Abstract

Background: Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project “ROUTE-HWF” (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies). Methods: We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes. Results: Two-hundred and forty studies were included (n = 116, 48% Australia/New Zealand; n = 105, 44% North America; n = 20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n = 171, 71%), characteristics (n = 95, 40%), contributing factors (n = 112, 47%), and approaches to mitigate medical deserts (n = 87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n = 55, 23%) and lifestyle-related factors (n = 33, 14%) of the HWF as well as sociodemographic characteristics (n = 79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n = 67, 28%), HWF distribution (n = 3, 1%), support/infrastructure (n = 8, 3%) and innovative models of care (n = 7, 3%). Conclusion: Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues. © 2023 The Author(s); Published by Kerman University of Medical Sciences.

Keywords

Author Keywords

Health workforce approaches Characteristics Contributing Factors Definition Medical Desert

Index Keywords

human Humans Australia health workforce empirical research Europe factual database Databases, Factual
Author Affiliations
Nederlands Instituut voor Onderzoek van de Gezondheidszorg, Utrecht, Utrecht, Netherlands
Avedis Donabedian Research Institute, Madrid, Madrid, Spain
Innovation and Entrepreneurship (InnoLab), Vaasan Yliopisto, Vaasa, Ostrobothnia, Finland
Department of Health Policy and Management, Uniwersytet Jagielloński, Krakow, Małopolska, Poland
Department of Health Economics and Social Security, Uniwersytet Jagielloński, Krakow, Małopolska, Poland
University of Zagreb School of Medicine, Zagreb, Croatia
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
Nederlands Instituut voor Onderzoek van de Gezondheidszorg, Utrecht, Utrecht, Netherlands, Department of Sociology, Radboud Universiteit, Nijmegen, Gelderland, Netherlands
Funding & Acknowledgements
Ministerstwo Edukacji i Nauki, MNiSW
This work was co-funded by the European Union’s Health Programme (2014-2020) under grant agreement no. 101018379 - ROUTE-HWF. The publication is co-funded by the Polish Ministry of Education and Science within the project “PMW” in the years 2021-2024; agreement no. 5176/HP3/2021/2.
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