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Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce.
Hum Resour Health. 2020 09 03; 18(1):63
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Birgit Abelsen
Roger Strasser
David Heaney
Peter Berggren
Sigurður Sigurðsson
Helen Brandstorp
Jennifer Wakegijig
Niclas Forsling
Penny Moody-Corbett
Gwen Healey Akearok
Anne Mason
Claire Savage
Pam Nicoll
Author Affiliation
The National Centre for Rural Medicine, The Department of Community Medicine, UiT, Tromsø, Norway.
Hum Resour Health. 2020 09 03; 18(1):63
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Recruiting and retaining a skilled health workforce is a common challenge for remote and rural communities worldwide, negatively impacting access to services, and in turn peoples' health. The research literature highlights different factors facilitating or hindering recruitment and retention of healthcare workers to remote and rural areas; however, there are few practical tools to guide local healthcare organizations in their recruitment and retention struggles. The purpose of this paper is to describe the development process, the contents, and the suggested use of The Framework for Remote Rural Workforce Stability. The Framework is a strategy designed for rural and remote healthcare organizations to ensure the recruitment and retention of vital healthcare personnel.
The Framework is the result of a 7-year, five-country (Sweden, Norway, Canada, Iceland, and Scotland) international collaboration combining literature reviews, practical experience, and national case studies in two different projects.
The Framework consists of nine key strategic elements, grouped into three main tasks (plan, recruit, retain). Plan: activities to ensure that the population's needs are periodically assessed, that the right service model is in place, and that the right recruits are targeted. Recruit: activities to ensure that the right recruits and their families have the information and support needed to relocate and integrate in the local community. Retain: activities to support team cohesion, train current and future professionals for rural and remote health careers, and assure the attractiveness of these careers. Five conditions for success are recognition of unique issues; targeted investment; a regular cycle of activities involving key agencies; monitoring, evaluating, and adjusting; and active community participation.
The Framework can be implemented in any local context as a holistic, integrated set of interventions. It is also possible to implement selected components among the nine strategic elements in order to gain recruitment and/or retention improvements.
PubMed ID
32883287 View in PubMed
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Int J Technol Assess Health Care. 2015;31(6):371-9
Publication Type
Ruth Puig-Peiro
Anne Mason
Jorge Mestre-Ferrandiz
Adrian Towse
Clare McGrath
Bengt Jonsson
Int J Technol Assess Health Care. 2015;31(6):371-9
Publication Type
Age Factors
Antineoplastic Agents - therapeutic use
Breast Neoplasms - drug therapy - mortality
Comparative Effectiveness Research
England - epidemiology
Risk factors
Socioeconomic Factors
Spain - epidemiology
Survival Analysis
Sweden - epidemiology
Technology Assessment, Biomedical - methods
Pharmaceuticals' relative effectiveness has come to the fore in the policy arena, reflecting the need to understand how relative efficacy (what can work) translates into added benefit in routine clinical use (what does work). European payers and licensing authorities assess value for money and post-launch benefit-risk profiles, and efforts to standardize assessments of relative effectiveness across the European Union (EU) are under way. However, the ways that relative effectiveness differs across EU healthcare settings are poorly understood.
To understand which factors influence differences in relative effectiveness, we developed an analytical framework that treats the healthcare system as a health production function. Using evidence on breast cancer from England, Spain, and Sweden as a case study, we investigated the reasons why the relative effectiveness of a new drug might vary across healthcare systems. Evidence was identified from a literature review and national clinical guidance.
The review included thirteen international studies and thirty country-specific studies. Cross-country differences in population age structure, deprivation, and educational attainment were consistently associated with variation in outcomes. Screening intensity appeared to drive differences in survival, although the impact on mortality was unclear.
The way efficacy translates into relative effectiveness across health systems is likely to be influenced by a range of complex and interrelated factors. These factors could inform government and payer policy decisions on ways to optimize relative effectiveness, and help increase understanding of the potential transferability of data on relative effectiveness from one health system to another.
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PubMed ID
26788883 View in PubMed
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