The iMpact on practice, oUtcomes and costs of New roles for health pROfeSsionals: a study protocol for MUNROS
Apostolos Tsiachristas,
James McDonald,
Christine Bond,
Hanne Bruhn,
Reinhard Busse,
Jonathan Gibson,
Iris Wallenburg,
Diane Skåtun,
Daryll Archibald,
Mandy Ryan,
Antoinette de Bont,
Job van Exel,
Matthew Sutton,
Robert Elliott,
Frantisek Vlcek,
Marie Zvoníčková,
Daniel Hodyc,
Hana Svobodová,
Steve Birch,
Britta Zander,
Julia Köppen,
Juliane Stahl,
Silvia Coretti,
Paola Codella,
Matteo Ruggeri,
Marianne Luyendjk,
Maarten Janssen,
Mathijs Kelder,
Maureen Rutten-van Molken,
Jon Opsahl,
Linda Ostergren,
Muhammad Kamrul Islam,
Nina Berven,
Kjell Haug,
Bjarte Folkestad,
Kari Ludvigsen,
Bodil Ravneberg,
Jan Erik Askildsen,
Alicja Sobczak,
Grażyna Dykowska,
Małgorzata Winter,
Sabina Ostrowska,
Michal Mijal,
Debbie MaClaggan,
Sebastian Heidenreich,
Sinem Erincç,
Seda Basihos,
Meryem Dogan,
Z Güldem Ökem
Affiliations
Apostolos Tsiachristas
PhD candidate
James McDonald
Rhode Island Department of Health, Providence, Rhode Island, USA
Christine Bond
emeritus professor
Hanne Bruhn
2 Health Services Research Unit, University of Aberdeen, Aberdeen, UK
Reinhard Busse
4Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
Jonathan Gibson
Health Organisation, Policy and Economics Research Group, Centre for Primary Care & Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
Iris Wallenburg
Diane Skåtun
Daryll Archibald
Department of Public Health, La Trobe University, Melbourne, Victoria, Australia
Mandy Ryan
2 Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
Antoinette de Bont
2Institute of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
Job van Exel
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
Matthew Sutton
5Institute of Population Health, University of Manchester, Manchester, UK
Robert Elliott
1Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Introduction The size and composition of the European Union healthcare workforce are key drivers of expenditure and performance; it now includes new health professions and enhanced roles for established professions. This project will systematically analyse how this has contributed to health service redesign, integration and performance in 9 European countries (Scotland, England, Netherlands, Germany, Italy, Czech Republic, Poland, Norway, and Turkeyi). This paper describes the protocol for collection of survey data in 3 distinct care pathways, and sets it in the context of the wider programme.Methods Questionnaires will be distributed to healthcare professionals (n=14 580), managers (n=3564) and patients (n=19 440) in 3 care pathways (breast cancer; type 2 diabetes; and coronary heart disease) within 12 hospitals and associated primary care settings in each country. Questionnaire topics will include demography, the different professionals working on the care pathway, the tasks they do and the time taken, their decision-making abilities when considering skill mix, specialisation and integration of care. Patient satisfaction, healthcare utilisation and preferences will be explored. In later work, register data and data from patient records will be used to record clinical outcomes. Data will also be collected on workforce and procedure costs. Descriptive analysis will identify the different models of care and multivariate analysis will establish the most clinically and cost-effective models.Ethics and dissemination This protocol was approved by ethical committees in each country. Findings will be disseminated through national/international clinical, health services research and health workforce conferences, and publications in national/international peer-reviewed journals.
