Policy challenges for the pediatric rheumatology workforce: Part III. the international situation.
Policy challenges for the pediatric rheumatology workforce: Part III. the international situation.
复制标题
DOI：
10.1186/1546-0096-9-26
复制
发表时间：
2011-09-12
期刊：
影响因子：
--
通讯作者：
Henrickson M
中科院分区：
文献类型：
--
作者：
Henrickson M
生存是当前儿科全球卫生优先事项。贫穷疾病在很大程度上造成了5岁以下儿童的总死亡率。传染性疾病和伤害占5-14岁儿童特定死因死亡率的75%。世界上20%的人口生活在极端贫困中（每天收入低于1.25美元）。在这些人口中，基本服务和基本需求得不到满足，包括清洁水、卫生设施、充足的营养、住房、获得保健、药品和教育的机会。在这种情况下，肌肉骨骼疾病占5-14岁儿童全因死亡率的0.1%。在世界范围内，肌肉骨骼疾病在儿童年龄组的发病率普遍未知。包括世界卫生组织在内的国际机构没有对这些流行病学数据进行常规调查。根据发达国家的数据，儿童风湿病的患病率为每百万儿童2500 - 3000例。随着儿童死亡的主要原因逐渐平息，发展中国家对肌肉骨骼疾病的需求正在经历一种向慢性病的流行病学转变。卫生保健提供者和人力资源的全球危机源于劳动力生产不足、无法在最需要的领域留住工人、分布不均以及卫生保健系统和卫生人力管理不善。在国际上，相对于预计的需求，在可预见的未来，儿科风湿病工作人员的供应也将非常短缺。在服务不足的地区，医师扩展人员是满足这一需求的重要资源。他们可以在肌肉骨骼医学和风湿病的常见方面接受培训。创新的策略已经在英国引入，以解决肌肉骨骼医学教育的不足。远程医疗提供了一种重要的能力，可以在距离遥远的情况下改善获得保健的机会。监管灵活性可允许通过现有和未来的政府或非政府认证组织重新调整临床责任。本综述探讨了各种创造性的方法，这些方法有望改善患者获得护理的机会。
Survival dominates current pediatric global health priorities. Diseases of poverty largely contribute to overall mortality in children under 5 years of age. Infectious diseases and injuries account for 75% of cause-specific mortality among children ages 5-14 years. Twenty percent of the world's population lives in extreme poverty (income below US $1.25/day). Within this population, essential services and basic needs are not met, including clean water, sanitation, adequate nutrition, shelter, access to health care, medicines and education. In this context, musculoskeletal disease comprises 0.1% of all-cause mortality in children ages 5-14 years. Worldwide morbidity from musculoskeletal disease remains generally unknown in the pediatric age group. This epidemiologic data is not routinely surveyed by international agencies, including the World Health Organization. The prevalence of pediatric rheumatic diseases based on data from developed nations is in the range of 2,500 - 3,000 cases per million children. Developing countries' needs for musculoskeletal morbidity are undergoing an epidemiologic shift to chronic conditions, as leading causes of pediatric mortality are slowly quelled. A global crisis of health care providers and human resources stems from insufficient workforce production, inability to retain workers in areas of greatest need, distribution disparity and poor management of both health care systems and health workforce. Internationally, the pediatric rheumatology workforce will also be in very short supply for the foreseeable future relative to projected demand. Physician extenders are an essential resource to meet this demand in underserved regions. They can be trained in common aspects of musculoskeletal medicine and rheumatic conditions. Innovative strategies have been introduced in the United Kingdom to address musculoskeletal medicine educational deficiencies. Telemedicine offers an important capacity to improve access to care despite distance. Regulatory flexibility may allow realignment of clinical responsibilities through existing and future governmental or non-governmental credentialing organizations. This review explores a variety of creative approaches which hold promise to improve patient access to care.
登录
查看更多内容
DOI：
10.1002/art.22230
发表时间：
2006-10-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Foster, H. E.;Kay, L. J.;Myers, A.
通讯作者：
Myers, A.
影响因子：
4.4
作者：
Pelkonen, P
通讯作者：
Pelkonen, P
影响因子：
168.9
作者：
Murray, Christopher J. L.;Loakso, Thomas;Lopez, Alan D.
通讯作者：
Lopez, Alan D.
影响因子：
168.9
作者：
Bryce, J;Boschi-Pinto, C;Black, RE
通讯作者：
Black, RE
DOI：
10.1186/1546-0096-5-21
发表时间：
2007-11-21
期刊：
Pediatric rheumatology online journal
影响因子：
--
作者：
Spencer, Charles H
通讯作者：
Spencer, Charles H