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A mobilidade dos profissionais de saúde em países europeus e os seus efeitos no desempenho e qualidade dos serviços de saúde: um estudo com profissionais de saúde portugueses em países da União Europeia e Suíça
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Introdução: A mobilidade de profissionais de saúde dentro e fora dos países da União Europeia cria a maior região de livre circulação para profissionais de saúde, colocando também novos desafios à integração e regulação dos sistemas e serviços de saúde. Com o desenvolvimento da UE, é assegurada a deslocação e o estabelecimento de profissionais de saúde em diferentes países da UE. A livre circulação e os fluxos migratórios contribuem para a prestação de cuidados de saúde durante períodos de carência de profissionais, sendo também motivados pela procura do desenvolvimento de competências e experiência profissional, melhoria de condições financeiras e socioeconómicas, oportunidades de carreira ou de formação. Objetivos: Investigar de que forma a mobilidade de profissionais de saúde afeta a cultura organizacional e profissional das instituições, (analisando dimensões como motivos, vantagens, desvantagens, barreiras e diferenças observadas) e o desempenho de serviços de saúde (recorrendo a uma análise de indicadores de qualidade, segurança e acesso de serviços de saúde), bem como no desenvolvimento e aprendizagem dos profissionais, através da análise de dimensões definidas de acordo com a literatura (como o acesso a oportunidades, acesso a informação, acesso a recursos, criatividade e colaboração). Metodologia: Foi realizada uma trilogia de estudos (um estudo de metodologia qualitativa, com entrevistas a profissionais de saúde, dois estudos de metodologia quantitativa, sendo um questionário para profissionais de saúde e uma análise de indicadores de desempenho) e uma revisão sistemática de literatura, tendo sido feita uma recolha de dados primários e secundários, a nível nacional. Resultados: A mobilidade de profissionais de saúde é percebida como uma experiência positiva, que contribui para o desenvolvimento profissional e para a diversificação de conhecimento. Os profissionais de saúde portugueses apresentam perceções positivas relativamente às dimensões “acesso à oportunidade”, “acesso à informação”, “acesso ao apoio profissional” e “colaboração entre pares”, apresentando perceções negativas ou muito negativas nas dimensões de “acesso a recursos” e “recompensa”. Foram observadas dimensões latentes relativas à motivação e satisfação: as características da instituição, organização do trabalho, colaboração e cooperação e a qualidade do trabalho, profissional, não tendo sido encontradas alterações no desempenho e dos serviços de saúde, decorrentes do recurso a profissionais exteriores às instituições de saúde. Conclusões: Dos resultados obtidos sobre a mobilidade dos profissionais de saúde em países da UE e Suíça concluiu-se que um dos principais fatores determinantes para a saída destes profissionais são motivos financeiros e remuneratórios, parecendo não haver efeitos a nível do desempenho e qualidade dos serviços de saúde. Verificou-se também a necessidade de desenvolvimento de sistemas e políticas de recolha de informação sobre os fluxos de profissionais, para uma melhor gestão de recursos humanos em saúde e melhores resultados em saúde.
Introduction: Mobility of health professionals in the European Union regions and EU countries, creates the largest free movement region for health professionals, also posing new challenges to the integration and regulation of health systems and services. With the development of the EU, the movement and establishment of health professionals in European countries are ensured. Free movement and migration flows contributes to the provision of health care during periods of shortage of professionals and are also motivated by the search for the development of skills and increased professional experience, improvement of financial and socio-economic conditions, and career or training opportunities. Objectives: To investigate how the mobility of health professionals affects the organizational and professional culture of institutions (analyzing dimensions such as motives, advantages, disadvantages, barriers and differences observed) and the performance of health services (using an analysis of indicators of quality, safety and access of health services), as well as the development and learning of professionals, through the analysis of dimensions defined according to the literature (such as “access to opportunities”, “access to information”, “access to resources”, “creativity” and “collaboration”). Methodology: A trilogy of studies was performed (a study of qualitative methodology, with interviews to health professionals and two studies of quantitative methodology, such as a questionnaire for health professionals and an analysis of performance indicators), and a systematic literature review of published studies. At national level, a series of primary and secondary data were collected. Results: Health workers mobility is perceived by health professionals as a positive experience that contributes to professional development, knowledge and skills acquisition; Portuguese health professionals have positive perceptions regarding the dimensions of "access to opportunity", "access to information", "access to professional support", and "peer collaboration", presenting negative or very negative perceptions in the dimensions of "access to resources" and "reward." The institution's characteristics, work organization, collaboration and cooperation and the quality of work were latent dimensions observed concerning motivation and professional satisfaction. No changes were found regarding performance and quality of health services resulting from recurring to external health professionals in health institutions. Conclusions: Results obtained from this study on health professional’s mobility in EU countries and Switzerland showed that the main motive for migration of these professionals are financial and remunerative reasons; no changes were found regarding health services quality and performance; However, there is a need for further development of information and data-collecting systems on health professionals flows, for a better management of human health resources and better health outcomes.
Introduction: Mobility of health professionals in the European Union regions and EU countries, creates the largest free movement region for health professionals, also posing new challenges to the integration and regulation of health systems and services. With the development of the EU, the movement and establishment of health professionals in European countries are ensured. Free movement and migration flows contributes to the provision of health care during periods of shortage of professionals and are also motivated by the search for the development of skills and increased professional experience, improvement of financial and socio-economic conditions, and career or training opportunities. Objectives: To investigate how the mobility of health professionals affects the organizational and professional culture of institutions (analyzing dimensions such as motives, advantages, disadvantages, barriers and differences observed) and the performance of health services (using an analysis of indicators of quality, safety and access of health services), as well as the development and learning of professionals, through the analysis of dimensions defined according to the literature (such as “access to opportunities”, “access to information”, “access to resources”, “creativity” and “collaboration”). Methodology: A trilogy of studies was performed (a study of qualitative methodology, with interviews to health professionals and two studies of quantitative methodology, such as a questionnaire for health professionals and an analysis of performance indicators), and a systematic literature review of published studies. At national level, a series of primary and secondary data were collected. Results: Health workers mobility is perceived by health professionals as a positive experience that contributes to professional development, knowledge and skills acquisition; Portuguese health professionals have positive perceptions regarding the dimensions of "access to opportunity", "access to information", "access to professional support", and "peer collaboration", presenting negative or very negative perceptions in the dimensions of "access to resources" and "reward." The institution's characteristics, work organization, collaboration and cooperation and the quality of work were latent dimensions observed concerning motivation and professional satisfaction. No changes were found regarding performance and quality of health services resulting from recurring to external health professionals in health institutions. Conclusions: Results obtained from this study on health professional’s mobility in EU countries and Switzerland showed that the main motive for migration of these professionals are financial and remunerative reasons; no changes were found regarding health services quality and performance; However, there is a need for further development of information and data-collecting systems on health professionals flows, for a better management of human health resources and better health outcomes.
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Saúde pública Mobilidade dos profissionais Países europeus Políticas de saúde Recursos humanos Europa