Health Policy最新文献

{"title":"Health workforce resilience in the age of polycrisis: A framework to support health workforce policy and planning","authors":"Olivier Onvlee ,&nbsp;Eelco Jacobs ,&nbsp;Noor Tromp ,&nbsp;Ajay Bailey ,&nbsp;Marjolein Dieleman","doi":"10.1016/j.healthpol.2025.105500","DOIUrl":"10.1016/j.healthpol.2025.105500","url":null,"abstract":"<div><h3>Background</h3><div>Many countries face prolonged health workforce crises, marked by shortages, maldistribution, skills mix imbalances and attrition. When workforces are overstretched, they become more vulnerable to external shocks and chronic strains, including infectious disease outbreaks, climate-related effects and political instability. This is particularly concerning as an emerging global “polycrisis” means such external pressures increasingly interact and amplify one another in unpredictable ways. Strengthening health workforce resilience must therefore become a priority for policy and planning.</div></div><div><h3>Objective</h3><div>To introduce a resilience lens for health workforce policy and planning.</div></div><div><h3>Methods</h3><div>This conceptual paper synthesises literature from health workforce and systems research, resilience, and complex adaptive systems theory, complemented by practical insights from workforce planning and governance.</div></div><div><h3>Results</h3><div>The paper introduces the Health Workforce Resilience framework, which illustrates how the multilevel nature of health workforce resilience connects individual health workers, teams and organisations, and the national health workforce level. It shows how shocks and long-term pressures ripple through these interconnected levels, affecting the capacity, composition, and performance of the workforce. Impacts and responses at one level can amplify or dampen effects at others. The framework highlights two critical interfaces: the workforce–community interface, capturing how societal, economic, and security conditions shape workforce motivation, performance, and retention, and the workforce–governance interface, reflecting how institutional arrangements, policies, and decision-making processes enable or constrain workforce system responses.</div></div><div><h3>Conclusions</h3><div>Adopting a resilience lens underscores the need to view workforce planning as a systems approach that emphasises anticipatory, needs-based planning and integrates political, social, and contextual realities to strengthen workforce resilience under pressure.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105500"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How are transitions from oncology to palliative care regulated across Europe? A grey literature review in eight countries: Pal-Cycles project","authors":"Eduardo Garralda ,&nbsp;Tamara Radojičić ,&nbsp;Sheila Payne ,&nbsp;Rachel Hooley ,&nbsp;Csilla Busa ,&nbsp;Ian Koper ,&nbsp;Wojciech Leppert ,&nbsp;Carla Reigada ,&nbsp;Flavia Hurducas ,&nbsp;Holger Brunsch ,&nbsp;Alazne Belar ,&nbsp;Carlos Centeno ,&nbsp;Jeroen Hasselaar ,&nbsp;María Arantzamendi","doi":"10.1016/j.healthpol.2025.105522","DOIUrl":"10.1016/j.healthpol.2025.105522","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced cancer often encounter significant challenges during the transition from oncology to palliative care, particularly due to hospital discharges that lack clear communication and follow-up plans. This discontinuity in care may be addressed through various regulatory strategies designed to facilitate smooth transitions.</div></div><div><h3>Objective</h3><div>To investigate the regulatory landscape governing transitions from oncology to palliative care across eight European countries.</div></div><div><h3>Methods</h3><div>A grey literature review followed by a comparative analysis of identified documents was carried out.</div></div><div><h3>Results</h3><div>A total of 20 professional guidelines, strategies, and regulations in England, Germany, the Netherlands, Portugal, and Spain were identified. Identified documents provided inconsistent guidance regarding the promotion of care continuity. Notably, several essential components for ensuring effective transitions were identified across countries: the formulation of collaborative protocols between various levels and types of care, the establishment of clear transition and referral criteria, early identification of palliative care needs, synchronization of patient information across care levels, involvement of family members in the care process, implementation of a comprehensive four-dimensional patient assessment, and regular evaluation and revision of care plans. Certain elements, such as the role of primary care professionals in identifying palliative care patients, realistic discharge timelines, effective communication with patients and families, and approaches to advance care planning and shared decision-making, were inconsistently identified across different countries.</div></div><div><h3>Conclusions</h3><div>To enhance continuity of care for patients transitioning from oncology to palliative care at different levels, it is imperative to develop targeted guidance that incorporates all pertinent elements of care coordination.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105522"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Romania’s 2025 guide for health workforce attraction and retention: Bridging global strategies and local realities","authors":"Teodor Cristian Blidaru ,&nbsp;Alina-Ioana Forray ,&nbsp;Tomas Zapata ,&nbsp;Cris Scotter ,&nbsp;Yana Andersen ,&nbsp;Khamis Al-alawy ,&nbsp;Ioana Novac ,&nbsp;Rareș Vrîncianu ,&nbsp;Alexandru Rafila ,&nbsp;Alexandru Florin Rogobete ,&nbsp;Dragoș Nicolae Garofil","doi":"10.1016/j.healthpol.2025.105511","DOIUrl":"10.1016/j.healthpol.2025.105511","url":null,"abstract":"<div><h3>Background</h3><div>Romania's health system faces a challenge of health workforce maldistribution, especially in rural and non-university urban areas. A national policy reform was launched in 2024–2025, supported by the National Recovery and Resilience Plan and WHO technical assistance. The reform's objective was to equip and empower local authorities to improve the recruitment, retention, and motivation of health professionals in their communities.</div></div><div><h3>Reform content</h3><div>The reform involves the development and nationwide dissemination of the “Solutions for Human Resources in Health: Guide of Local Actions”. Developed through a participatory, evidence-based process with stakeholders, this guide is a practical toolkit for local authorities and hospital managers. It consolidates underused legal frameworks and curates national and international best practices examples across four main pillars: Education, Incentives, Regulation, and Support.</div></div><div><h3>Expected Results</h3><div>The primary expected outcome is an improvement in the geographical distribution of the health workforce, resulting in better-staffed facilities in underserved regions. A key secondary outcome is the boost in local authorities' administrative capacity and proactive involvement in the health workforce management, which fosters greater ownership and a more sustainable, decentralized approach to addressing staffing challenges. These outcomes will become measurable over the medium-to-long term as local authorities implement the guide's provisions.</div></div><div><h3>Conclusions</h3><div>The collaborative, evidence-based process used for the guide exemplifies a best practice model for stakeholder-driven policy development. The Romanian experience provides a transferable framework for countries with decentralized health systems to empower local actors in addressing health workforce maldistribution, though long-term success depends on local implementation and political will.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105511"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer in Bulgaria since EU accession in 2007: a struggle in the face of political instability","authors":"Irina Todorova ,&nbsp;Yulia Panayotova ,&nbsp;Tatyana Kotzeva ,&nbsp;Rachel Greenley ,&nbsp;Martin McKee ,&nbsp;CBIG-SCREEN Consortium","doi":"10.1016/j.healthpol.2025.105497","DOIUrl":"10.1016/j.healthpol.2025.105497","url":null,"abstract":"<div><h3>Background</h3><div>Bulgaria has one of the highest cervical cancer incidence rates in the EU, driven by persistently low screening uptake and HPV vaccination coverage. Despite the preventable nature of the disease, efforts to implement effective prevention strategies have been undermined by political instability, fragmented governance, and systemic health system weaknesses.</div></div><div><h3>Reform Content</h3><div>Since EU accession in 2007, Bulgaria has launched several initiatives, including the “Stop and Get Checked” programme and the National Program for Primary Prevention of Cervical Cancer. These efforts were supported by EU policy frameworks and funding. The 2023 National Plan for Combating Cancer aims to align with Europe’s Beating Cancer Plan, proposing organised screening, expanded HPV vaccination (including boys), and improved public awareness. A new HPV prevention programme (2025–2030) sets ambitious coverage targets and introduces gender-neutral vaccination.</div></div><div><h3>Expected Results</h3><div>If implemented effectively, these reforms could significantly reduce cervical cancer incidence and mortality. Key expected outcomes include increased screening coverage, higher HPV vaccination rates, improved access for underserved populations, and better data collection and monitoring. The integration of EU-supported strategies offers a pathway to more consistent and sustainable progress.</div></div><div><h3>Conclusions</h3><div>Bulgaria’s experience highlights the challenges of implementing cancer prevention in politically unstable settings. While recent reforms show promise, success depends on sustained political commitment, adequate funding, and coordinated implementation. Lessons from Bulgaria may inform other countries facing similar governance challenges, underscoring the value of external policy frameworks and targeted, system-wide approaches.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105497"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On “Inequality in COVID-19 vaccine acceptance and uptake”","authors":"Zachary D.V. Abel ,&nbsp;Laurence S.J. Roope ,&nbsp;Raymond Duch ,&nbsp;Sophie Cole ,&nbsp;Philip M. Clarke","doi":"10.1016/j.healthpol.2025.105525","DOIUrl":"10.1016/j.healthpol.2025.105525","url":null,"abstract":"","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105525"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Working Patterns in Irish general practice: Findings from a Qualitative Remote Ethnographic Study","authors":"Niamh Humphries ,&nbsp;Holly R Hanlon ,&nbsp;Mike O’Callaghan ,&nbsp;John-Paul Byrne ,&nbsp;Laura Cullen ,&nbsp;Andrew W Murphy ,&nbsp;Susan M Smith ,&nbsp;Éidín Ní Shé","doi":"10.1016/j.healthpol.2025.105505","DOIUrl":"10.1016/j.healthpol.2025.105505","url":null,"abstract":"<div><h3>Background</h3><div>General practice in Ireland has changed significantly with increased participation of women in the workforce; a move from single-handed to group practices and an increased prioritisation of work life balance.</div></div><div><h3>Objective</h3><div>This paper explores how GP ways of working have changed. By presenting qualitative data from GPs in Ireland, we present GP perspectives on part and full time working and highlight the need to capture new ways of working by GPs (via research and routine data), and use it to inform GP workforce planning.</div></div><div><h3>Method</h3><div>To provide an in-depth exploration of GP working life, the study employed a qualitative method of remote ethnography which involved recruiting 20 GPs in Ireland, conducting two online interviews with each GP and conducting an eight-week discussion via Threema (instant messaging application). Data collection was conducted from October 2024 to July 2025. Research ethics permission was granted by the institutional ethics committee.</div></div><div><h3>Results</h3><div>GPs discussed heavy workloads and high work intensity, long working hours and a heavy burden of administrative work. They explained how reduced working hours and job crafting were used to reduce the intensity of their working week, achieve work-life balance and reduce their stress levels.</div></div><div><h3>Conclusion</h3><div>Participant GPs reported reducing the number of clinical sessions worked in order to protect their wellbeing and achieve work-life balance. These new ways of working must be evaluated using research and routine data collection to capture the work-as-done by GPs (rather than the work-as-imagined) in order to inform policy and GP workforce planning.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105505"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From recruitment to retention of young doctors: A comparative analysis of policies in Poland and the United Kingdom","authors":"Kamila Michalska ,&nbsp;Alejandro Gonzalez-Aquines ,&nbsp;Lynn McVey ,&nbsp;Gaynor Clark ,&nbsp;Alicja Domagała","doi":"10.1016/j.healthpol.2025.105513","DOIUrl":"10.1016/j.healthpol.2025.105513","url":null,"abstract":"<div><h3>Background</h3><div>European healthcare systems are facing shortages of physicians, which increases pressure on the recruitment and retention of young doctors.</div></div><div><h3>Objective</h3><div>This article aims to compare the solutions implemented for young doctors in Poland and the United Kingdom and to identify transferrable solutions between the systems.</div></div><div><h3>Methods</h3><div>A comparative analysis of public policies was conducted in April 2025 and was updated in August 2025 based on the five pillars of the WHO 2023–2030 framework and the healthcare labour market. The analysis comprised documents of the governments and international health organisations, legal acts, scientific and grey literature and additional consultations with national experts.</div></div><div><h3>Results</h3><div>In Poland, the remuneration of medical doctors (including interns and residents), as well as admission limits and number of institutions educating doctors, significantly increased. However, a comprehensive, long-term resource planning strategy is still lacking.</div><div>In the United Kingdom, the National Health Service Long Term Workforce Plan and 10 Point Plan were implemented to improve resident working conditions, complemented by wellbeing and flexible work organisation programs.</div></div><div><h3>Conclusions</h3><div>The policies for young doctors in Poland and the UK show differences in scale, consistency, and sustainability, but the comparison reveals a similar need for a long-term integrated strategy. Key issues include expanding training tailored to supervisory capabilities; replacing fragmented workplace-based incentive packages; making flexibility, mentoring and psychological safety permanent features of young doctors' work; and adapting curricula to digital, team-based care.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105513"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural competence teaching in public health: a rapid review to support implementation","authors":"Martina Paric ,&nbsp;Pablo Rodriguez Feria ,&nbsp;María del Carmen Calle ,&nbsp;Gloria Lagos ,&nbsp;Matt Commers ,&nbsp;Katarzyna Czabanowska","doi":"10.1016/j.healthpol.2025.105512","DOIUrl":"10.1016/j.healthpol.2025.105512","url":null,"abstract":"<div><h3>Background</h3><div>Efforts to strengthen the public health workforce increasingly emphasize cultural competence as essential for addressing health disparities. While widely recognized, approaches to teaching this competency in public health remain fragmented. With the shift towards competency-based education that is aligned with workforce needs, clarity on how to integrate cultural competence teaching is needed.</div></div><div><h3>Objective</h3><div>To understand what factors support and inhibit cultural competence teaching within the public health education sector.</div></div><div><h3>Methods</h3><div>A rapid review was conducted using the Cochrane Rapid Review Methods Guidance and the databases Medline (Pubmed), Embase (Ovid), and Ebsco host. Blinded screening of title and abstract was performed, with additional citation searches. Relevant data was collected, and qualitative findings were synthesised using thematic analysis. Critical appraisal was performed on all included articles. The review was registered to PROSPERO 2025 CRD420251016703.</div></div><div><h3>Results</h3><div>17 articles were included. Analysis identified 6 major themes and 27 subthemes. 3 themes focus on the context in which cultural competence is taught: leveraging connections to communities, overall institutional readiness of public health schools, and having the aim to develop culturally competent graduates. The remaining 3 themes focused on content: providing an overview of various teaching practices, educational content, and developing an environment for continuous cultural learning. One cross-cutting code that emerged, referred to the need for standardization across public health and other health and allied health programmes.</div></div><div><h3>Conclusions</h3><div>This review provides decision-makers in public health schools with insights to advance cultural competence teaching. Closer collaboration with stakeholders and public health professionals is encouraged.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105512"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragmentation of Health Benefits Plans in Chile: Findings from a comparative policy analysis and implications for advancing Universal Health Coverage","authors":"Pilar Contreras-Montiel ,&nbsp;Nicolás Armijo ,&nbsp;Macarena Vera ,&nbsp;Oscar Arteaga ,&nbsp;Pamela Góngora-Salazar ,&nbsp;Carlos Balmaceda ,&nbsp;Manuel A. Espinoza","doi":"10.1016/j.healthpol.2025.105507","DOIUrl":"10.1016/j.healthpol.2025.105507","url":null,"abstract":"<div><h3>Background</h3><div>Health Benefit Packages (HBPs) are essential for advancing universal health coverage (UHC) globally. In Chile, a fragmented and segmented health system includes multiple HBPs. Understanding their characteristics is crucial to inform policy debates on whether to maintain multiple HBPs or move toward a unified national plan.</div></div><div><h3>Objective</h3><div>To characterize Chile’s HBPs by examining their foundations, mechanisms for defining and updating covered services, and their interactions with health system functions and outcomes.</div></div><div><h3>Methods</h3><div>We conducted a document review informed by methodological approaches from rapid reviews. Primary sources included laws, decrees, regulations, and technical norms governing HBPs in Chile, complemented by information from institutional websites and selected grey literature. Data were systematized using a conceptual matrix with three domains and twelve dimensions capturing the main elements of any HBP.</div></div><div><h3>Results</h3><div><strong>S</strong>even HBPs were identified, including the \"Explicit Health Guarantees Plan\" and the \"Ricarte Soto Law\", the \"High-Cost Oncological Drugs Fund\", and the essential HBP for the public, private and the armed forces and security forces system. Significant variability was found across eight of the twelve dimensions, particularly regarding health technology assessment mechanism. Similarities were observed in principles, laws, healthcare provisions, and regulatory dimensions.</div></div><div><h3>Conclusions</h3><div>Maintaining multiple HBPs may hinder equitable access to health services. We recommend that Chile advance toward harmonizing or unifying the set of services into a universal HBP, supported by a robust HTA mechanism to ensure transparency and fairness. This approach could enhance the effectiveness of the health system and help achieve UHC.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"164 ","pages":"Article 105507"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different systems, same challenges: a comparative analysis of long-term care resilience in Norway, Finland, the Netherlands, Romania, Spain, Italy and Australia","authors":"Martijn Felder ,&nbsp;Roland Bal ,&nbsp;Eline Ree ,&nbsp;Maren Sogstad ,&nbsp;Sharon Stoddart ,&nbsp;Louise A. Ellis ,&nbsp;Florin Tibu ,&nbsp;Federico Vola ,&nbsp;Paola Cantarelli ,&nbsp;Juana María Delgado-Saborit ,&nbsp;Estefania Aparicio ,&nbsp;Mari Lahti ,&nbsp;Eila Kankaanpää ,&nbsp;Siri Wiig ,&nbsp;Iris Wallenburg ,&nbsp;Hilda Bø Lyng","doi":"10.1016/j.healthpol.2025.105484","DOIUrl":"10.1016/j.healthpol.2025.105484","url":null,"abstract":"<div><h3>Background</h3><div>Welfare states face multiple challenges in the sustainable organization of their long-term care (LTC) systems due to aging populations and structural workforce shortages. In this context, the need emerges to facilitate cross-country exchange of policy responses to strengthen LTC resilience.</div></div><div><h3>Objectives</h3><div>In this paper, we provide comparative insight into the LTC systems of Norway, Finland, the Netherlands, Romania, Spain, Italy, and Australia. We identify key challenges in organizing LTC in these systems and compare strategies implemented to enhance LTC resilience.</div></div><div><h3>Methods</h3><div>Our qualitative cross-country analysis is based on the Consolidated Framework for Implementation Research and adapted for LTC contexts. Data was derived from OECD databases and complemented with country specific publicly available data sources.</div></div><div><h3>Results</h3><div>We show that participating countries face similar workforce challenges and adopt comparable strategies such as aging-in-place policies, technological innovation, service integration, and task shifting. Subtle yet crucial differences can however be observed in the broader systemic conditions in place to support LTC employment, and in the trade-offs being made between care quality and accessibility. The differences highlight the crucial role of LTC organizations and particularly middle managers in translating workforce strategies into situated interventions that strengthen both organizational resilience and individual well-being.</div></div><div><h3>Conclusions</h3><div>To enhance LTC resilience in both the short and long term, translational challenges include strengthening the connections to informal carers; stabilizing ehealth technologies to support ageing-in-place; and balancing individual workers’ ambitions and needs with organizational goals to keep healthcare accessible, responsive and of good quality.</div></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"163 ","pages":"Article 105484"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}