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May 25, 2026Archives of Public Health0 citationsOpen Access

Sustaining the nursing workforce in ageing health systems: evidence from trend in entries, exits and capacity projections in Czechia

SJSimona JíchováTPTereza PatákováLŠLuděk Šídlo

Key Points

  • This study aims to describe the age structure and patterns of nurses entering and exiting the Czech healthcare system while projecting potential nursing shortages.
  • Retrospective observational study utilizing data from the General Health Insurance Company of the Czech Republic from 2012 to 2023.
  • Demographic methods to evaluate age structures and entry-exit patterns of nurses.
  • Compilation of a projection model for nursing capacities up to 2035.
  • Aging trend observed with increasing proportions of older nurses and a decline in younger groups.
  • Projections for 2035 indicate a potential decline of up to 8% in both full-time equivalent capacity and headcounts compared to 2022.
  • Emphasis on the need for targeted planning and improved conditions for nursing graduates to address expected shortages.

Abstract

Abstract Background The ageing and shortage of healthcare workers represents a major problem in many countries worldwide, including Czechia. This study focuses specifically on nurses in the Czech healthcare system. The aims of the article are to describe the age and geographical structures of nurses and analyse their entry into and exit from the healthcare system, as well as to provide projections aimed at highlighting the potential risks of a shortage of nurses. Methods This retrospective observational study utilised data from the largest Czech health insurance company (the General Health Insurance Company of the Czech Republic (GHIC)), which has concluded contracts with almost all healthcare providers in Czechia, for the period from 31 December 2012 to 30 September 2023. Demographic methods were used to evaluate the age structures and entry and exit patterns, which was followed by the compilation of a “what-if” projection model of nursing capacities up to 2035. Results The analysis revealed a clear ageing trend across all the country’s healthcare segments, as reflected in the increasing proportion of nurses in older age groups and the declining representation of younger age groups. If current entry and exit trends continue, projections for 2035 predict declines in both the full-time equivalent capacity (FTE) and physical capacity (headcounts) of up to 8% compared to the year 2022. Conclusions The study points to the need for targeted planning, improved entry conditions for nursing graduates and support for personnel retention, especially in regions and care sectors most at risks of shortages. It further highlights the importance of implementing policies that ensure the long-term sustainability of the nursing workforce in an ageing healthcare system.

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Cite This Study

Jíchová et al. (2026) studied this question.

synapsesocial.com/papers/6a13e83b0e02ee3982d32ec5https://doi.org/10.1186/s13690-026-01965-5
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