Secondary outcomes are: patient satisfaction; general practitioners workload; quality and safety of care and barriers and facilitators.
Other factors include physical workload, quality of recipient contact, physical environment, type of patient feedback, financial pressures and supervisor support [ 22].
Policy makers will have to be confident that staffing mix, locally and nationally, are based on a rational assessment of workload, quality and appropriate skills, rather than being driven only by any changes in supply.
Alternative methods for histologic recognition can greatly aid in alleviating workloads, assuring quality control and reducing costs [ 6].
This might reflect the effect of rapid scale-up and subsequently higher workloads on quality of care.
This suggests that the increase in LTFU might be related to rapid ART scale-up in large urban cohorts where the impact of high workloads on quality of care would be significant.
To prevent damage to healthcare system when discrepancy appears between the observed and the predicted PD, we should examine not only the status of physician manpower, but also the physicians' workloads, the quality of medical performance, the physicians' well-being, the effectiveness of health promotional program and the team resource management.
While the impact of these losses has not been thoroughly studied, it has been suggested that migration means a loss of the investment made in health workforce development, which creates equity and distribution problems within the country's health systems and causes high workloads, poor quality of care and low morale among health workers [ 8, 9].
2. Gurses AP et al. Impact of performance obstacles on intensive care nurses' workload, perceived quality and safety of care and quality of working life.
In the service operation stage, energy efficiency has been extensively studied and has focused for example on approaches towards energy management for distributed management of VMs in cloud infrastructures, where the goal is to improve the utilization of computing resources and reduce energy consumption under workload independent quality of service constraints [15].
