The geriatric workforce: is there anybody out there to care in Romania?

Abstract Background Demographic changes - such as population ageing - pose great challenges to health systems around the world. For the Romanian health system, challenges might be particularly difficult to address. Facing a severe under-funding and significant workforce maldistribution, the health system in Romania is called to care about both the ageing population and the workforce taking care of the elderly. The aim of this paper is to apply the health labour market framework to the geriatric workforce in Romania. Methods The paper describes the composition and distribution of the geriatrics workforce in Romania based on data in the Healthcare Facility Activity report, policy documents and available reports. Results Geriatric care is provided in Romania mainly by geriatricians employed by public hospitals. The team around geriatricians is limited to nurses only, with other professions - such as psychologists, physiotherapists and social workers - almost absent. Even though the number of geriatricians has increased country-wide over recent years (from 149 to 242), there are significant differences in their distribution at a county level. Eleven counties out of the 41 reporting to have only 1 geriatrician for populations of hundreds of thousands. Training curricula for geriatrics residents fall short of addressing team work and inter-professional collaboration. Reports show growing concern over geriatrician burnout, caused in part by inadequate team work. Faced with burnout risk, many of them report considering changing specialties, which would further aggravate the lack of comprehensive elderly care. Conclusions The geriatrics workforce in Romania is poorly developed, and significant efforts are still needed to develop policies addressing geriatrics production, inflows and outflows, and maldistribution and inefficiencies. Moreover, addressing burnout by improving teamwork and collaboration is vital for maintaining and improving the workforce morale and motivation.