Report on the Literature Review Results from the Literature Review concerning “Counteracting brain drain and professional isolation of health professionals in remote primary health care through teleconsultation and telementoring to strengthen social conditions in remote BSR“. Output no. 3.1 Irina Moroz Laura Prett Kaija Loppela, Kristiina Vaahtera, Minna Kamula Bosco Lehr, Katrin Olenik Aigars Miezitis, Madara Vegnere Darius Jegelevičius Anna-Lena Nilsson, Sture Eriksson Output no. 3.1 Output title: Report on transnational literature review Belarus: Irina Moroz Estonia: Laura Prett Finland: Kaija Loppela, Kristiina Vaahtera, Minna Kamula Authors: Germany: Bosco Lehr, Katrin Olenik Latvia: Aigars Miezitis, Madara Vegnere Lithuania: Darius Jegelevičius Sweden: Anna-Lena Nilsson, Sture Eriksson Reviewer: Sami Perälä, South Ostrobothnia Healthtechnology Development Centre (EPTEK) Needs and strategies to counteract brain drain and professional isolation in remote WP title: primary health care through teleconsultation and telementoring Date: 2012.06.25 Page 2 / 105 Output no. 3.1 Output title: Report on transnational literature review Table of Contents Short Abstract ........................................................................................................................ 7 1 Introduction ................................................................................................................ 7 2 Methods ..................................................................................................................... 9 3 Country specific literature review...............................................................................10 3.1 Description of the regions ......................................................................................10 3.1.1 Belarus ..............................................................................................................10 3.1.2 Estonia ...............................................................................................................12 3.1.3 Finland ...............................................................................................................16 3.1.4 Germany ............................................................................................................19 3.1.5 Latvia .................................................................................................................22 3.1.6 Lithuania ............................................................................................................24 3.1.7 Sweden ..............................................................................................................29 3.1.8 Key indicators of the healthcare systems ...........................................................31 3.2 Definition of professional isolation and brain drain .................................................33 3.2.1 Belarus ..............................................................................................................33 3.2.2 Estonia ...............................................................................................................34 3.2.3 Finland ...............................................................................................................35 3.2.4 Germany ............................................................................................................36 3.2.5 Latvia .................................................................................................................37 3.2.6 Lithuania ............................................................................................................37 3.2.7 Sweden ..............................................................................................................38 3.2.8 Conclusion for the definitions .............................................................................38 3.3 Effects of professional isolation .............................................................................40 3.3.1 Belarus ..............................................................................................................40 3.3.2 Estonia ...............................................................................................................41 3.3.3 Finland ...............................................................................................................42 3.3.4 Germany ............................................................................................................43 3.3.5 Latvia .................................................................................................................44 3.3.6 Lithuania ............................................................................................................45 3.3.7 Sweden ..............................................................................................................45 3.3.8 Comparison of country-specific effects ...............................................................45 3.4 Factors leading to professional isolation and brain drain .......................................46 3.4.1 Belarus ..............................................................................................................46 3.4.2 Estonia ...............................................................................................................46 3.4.3 Finland ...............................................................................................................48 3.4.4 Germany ............................................................................................................49 3.4.5 Latvia .................................................................................................................49 3.4.6 Lithuania ............................................................................................................50 3.4.7 Sweden ..............................................................................................................50 3.4.8 Comparison of country-specific factors ..............................................................51 3.5 Weighting of professional isolation compared to other factors that enhance brain drain .............................................................................................................52 3.5.1 Belarus ..............................................................................................................52 Page 3 / 105 Output no. 3.1 Output title: Report on transnational literature review 3.5.2 Estonia ...............................................................................................................52 3.5.3 Finland ...............................................................................................................52 3.5.4 Germany ............................................................................................................53 3.5.5 Latvia .................................................................................................................54 3.5.6 Lithuania ............................................................................................................54 3.5.7 Sweden ..............................................................................................................54 3.5.8 Comparison of the weighting factors ..................................................................55 3.6 On-going teleconsultation and telementoring .........................................................56 3.6.1 Belarus ..............................................................................................................56 3.6.2 Estonia ...............................................................................................................57 3.6.3 Finland ...............................................................................................................58 3.6.4 Germany ............................................................................................................61 3.6.5 Latvia .................................................................................................................63 3.6.6 Lithuania ............................................................................................................66 3.6.7 Sweden ..............................................................................................................68 3.6.8 Comparison of ongoing projects .........................................................................69 3.7 Specific requirements on tele-services ..................................................................71 3.7.1 Belarus ..............................................................................................................71 3.7.2 Estonia ...............................................................................................................71 3.7.3 Finland ...............................................................................................................71 3.7.4 Germany ............................................................................................................72 3.7.5 Latvia .................................................................................................................72 3.7.6 Lithuania ............................................................................................................72 3.7.7 Sweden ..............................................................................................................73 4 Summary and interpretation of main results ..............................................................74