Worldwide assessment of healthcare personnel dealing with lymphoedema

Abstract

Background: Lymphoedema is a pandemic with about 250 million people suffering from this condition worldwide. Lymphatic diseases have considerable public health significance, but yet few professionals are specialised in their management causing a substantial burden on health resources.

Aims and objectives: This study aims to give an overview of the approximate number of medical professionals, professional societies, institutions and companies dealing with lymphoedema in various countries. Concepts of improvement for current human resources are considered.

Methods: An online database analysis (Google search engine and PubMed) was carried out for each country of the world. Additionally, relevant congress participant lists as well as member lists of significant medical societies and reports of the World Health Organisation were analysed.

Results: Overall distribution of tertiary level professionals specialised in this field is heterogenous. A decrescent gradient of professionals can be seen between developed and developing countries and between urban and rural areas. Countries in general do not seem to have yet met the current demand for specialists at tertiary level in this field.

Conclusions: This study intends to draw attention to the current medical coverage gaps due to a low number of lymphoedema specialists at tertiary level. It wishes to start a discussion about structured reimbursement and certification of knowledge and skills that are essential incentives for experts to act as multiplicators and change the lack of care in the mid-term. Current fail prescriptions and evitable disability and sick certificates represent a high financial burden that could be reinvested in a correct management. Policy makers must focus in the two above mentioned essential measures. Medical training and the consequent development of the industry will then naturally take place, as it was the case for other professional groups in the past.

Keywords: Lymphatic diseases; Lymphoedema; Lymphology; Medical education; Medical healthcare resources.

Fig. 1

Flowchart showing the systematic data search process including information on database structure and search terms

Fig. 2

Absolute distribution of professionals exclusively at tertiary level dedicated to lymphatic diseases across the world. The colour code scale shows white for zero professionals (e.g. Afghanistan or Kazakhstan) and black corresponds to the maximum number of 432 professionals found in Germany. The higher the absolute number of tertiary level professionals in a country, the darker the colour

Fig. 3

a Scatter plot of logarithmic ratio between tertiary level professionals and population for each continent, b Ratio of tertiary level professionals, physicians and researchers per million inhabitants for each continent, c Countries in Europe presenting the highest ratio of physicians per million inhabitants (bar chart)

Fig. 4

Geographical distribution of physicians in Spain in absolute numbers