Hot topic in geriatric medicineGeriatric care in Europe – the EUGMS Survey part I: Belgium, Czech Republic, Denmark, Germany, Ireland, Spain, Switzerland, United Kingdom
Introduction
Geriatric medicine is the specialty concerned with health related problems in older people, including acute, chronic and rehabilitation problems, in the community, long-stay and hospital settings [1]. It is of proven efficacy in health promotion, health gain, health maintenance and palliative care for older people. Geriatric medicine is an independent medical specialty in the majority of European Countries, but not in all, although the number of older patients and the complexity of their medical conditions are growing fast [2]. Indemnification and quality of geriatric medical care clearly depends on number and local density of specialized clinical resources. Therefore clinical departments and wards but also qualified personal, especially well trained physicians are of central importance. In this context every serious prediction about an adequate medical care of our aging societies will depend on statistical data of number and allocation of medical doctors specialized in geriatric medicine.
Experts have called for extended access to specialist Geriatric care for older patients admitted to European hospitals to offer coordinated and integrated multidisciplinary care, adapted to the needs of each individual, their families and caregivers [3].
Unfortunately, there are little data on the number of geriatricians in different European. It was the aim of this survey within the European Union Geriatric Medical Societies (EUGMS) member countries to give an overview of number and density of geriatricians in relation to national demographic data.
The European continent is ageing and health services are dealing with an increasing number of older patients, often well beyond their 80s. This phenomenon, known as “geriatrisation of medicine” calls for specialist care provided by trained and certified geriatricians who have knowledge and skills necessary for providing quality care for these patients. During the last two decades US and European countries have recognized an increasing gap between steadily growing number of geriatric patients and the number of geriatricians. Shortage of geriatric specialists is a threat to good medical and nursing care for older patients in developed countries and unavailability of such care discriminates against the aged persons [4].
In Europe, recognition of geriatric specialty/subspecialty varies widely among individual EU member countries. Undergraduate and postgraduate training of medical students and young specialists differs, as well as the position of academic geriatrics, number of geriatric beds [2]. European professional organizations (UEMS: Union Européenne des Médicins Spécialistes: European Union of Medical Specialists, EUGMS, IAGG: International Association of Gerontology and Geriatrics) have called for action (Silver paper). However, reliable prediction of specialists needs in Europe must be based on demographic projections and good quality of data of current numbers of specialist in geriatric medicine in European countries, their availability, and regional distribution.
Therefore EUGMS decided to conduct a survey with the aim to map the current situation in numbers and geographical distribution of geriatricians in relation to national demographic data.
Section snippets
Material and methods
National geriatric societies were invited to participate in an European survey, to give information about absolute and relative numbers of physicians certified as specialists in geriatric medicine and – if available – about their geographic distribution. As postgraduate education of specialists in geriatric medicine differs in individual European countries [5], a geriatrician was defined as a physician who completed formal specialist education according to national educational policy and became
Results
Rates of certified geriatric specialists differed extremely for ranking of all ten participating countries see Table 1.
Four countries, Czech Republic, Denmark, Germany and Spain reported more detailed regional data. It was of high interest to see, that within one nation there are existing wide variation of geriatric specialists. Table 2, Table 3, Table 4, Table 5, Czech Republic [2], Denmark [3], Germany [4] and Spain [5], show the detailed data of regional distribution.
In Germany there was a
Belgium (BEL)
Belgium is a small country with a very high degree of urbanization, which accounts for the absence of large differences between its provinces. The specialty of Geriatrics was officially introduced in 1985 as a separate subspecialty of Internal Medicine. Only recently, in 2005, the specialty was recognized as a specific specialty comparing with other subspecialties such as cardiology, pneumology. This also changed the structure of the training of residents. From 1985 through 2005 training
Addendum
All members of the EUGMS academic board were involved in the conception and design of the study; KG acquired data; KG interpreted the data and drafted the article; KG did the statistical analysis; Authors ARK, CJA, OD, TE and MJP gave advices, inputs and drafts; all other authors revised the article for important intellectual content. All authors finally approved the manuscript to be published.
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
Acknowledgment
We thank Mrs. Petra Landwehr for her excellent technical assistance.
References (16)
- et al.
European Union Geriatric Medicine Society. Position statement on geriatric medicine and the provision of health care services to older people
J Nutr Health Aging.
(2004) - et al.
Geriatrics from the European Union Perspective
- et al.
Silver paper: the future of health promotion and preventive actions, basic research, and clinical aspects of age-related disease–a report of the European Summit on Age-Related Disease
Aging Clin Exp Res.
(2009) - Retooling for an Aging America: Building the Health Care Workforce. National Academies Press, 2008,...
- et al.
Europe-wide survey of teaching in geriatric medicine
J Am Geriatr Soc
(2008) - Institute for Health Information and Statistics (UZIS)...
- et al.
Třicet let postgraduálního vzdělávání v gerontologii a geriatrii v České republice. (Thirty years of postgraduate training in gerontology and geriatrics in the Czech Republic)
Čes Geriatr Rev
(2004) - et al.
Teaching geriatric medicine in primary care–Experience of Slovakia, Hungary and Czech Republic
J Nutr Health Aging
(2006)
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Further Members of the EUGMS Academic Board: Chassagne P.(F), Vandewoude M., University Centre of Geriatrics, Antwerpen (B), Kenny R.A. (IR), Knight P., Royal Infirmary, Glasgow, (GB), Maggi St. (I), Masotti G. (I), Cherubini A. University of Perugia Medical School, Perugia, (I).