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[Task shifting: a derby between doctors and nurses or a resource for patients and health care systems?]
1Medico, anestesista-rianimatore.
Abstract:
As proved through a sound evidence, task shifting (TS) - the rational redistribution of tasks among health workforce teams - is an important strategy aimed at improving health of the most vulnerable and disadvantaged populations of the low- and middle-income countries by providing essential services and reducing or eliminating health inequalities. Clinical and epidemiological efficacy of many TS interventions has also been demonstrated in high-income countries. Systematic reviews show that TS can reduce morbidity and mortality by providing essential care for infectious and non-communicable diseases, for maternal and child health, for critically ill and injured patients. The results of some research programs concerning TS interventions offer a conceptualization and an in-depth evaluation of their positive effects on health equity. However, these results are often underestimated, or not considered, by medical institutions in some European countries such as Italy. On the contrary, the TS deserves greater attention and conceptual enhancement as a tool contributing to the development of new health care systems on one hand, and, on the other, to the renewal of the concept of health from the mere psycho-physical aspect to that connected to social risks in a society in which health inequalities continuously increase, affecting the most vulnerable groups. After providing a definition and clarifying the different implementation methods of TS, the article analyzes the key factors supporting its adoption and those that hinder it. Then, an assumption is put forward that TS could be part of a renewal process of both the public health care systems and the different health care professionals functions.
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