SEARCH · PubMed Health

Results for “Workforce”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMed2003

Lost productive time and cost due to common pain conditions in the US workforce.

CONTEXT: Common pain conditions appear to have an adverse effect on work, but no comprehensive estimates exist on the amount of productive time lost in the US workforce due to pain. OBJECTIVE: To measure lost productive time (absence and reduced performance due to common pain conditions) during a 2-week period. DESIGN AND SETTING: Cross-sectional study using survey data from the American Productivity Audit (a telephone survey that uses the Work and Health Interview) of working adults between August 1, 2001, and July 30, 2002. PARTICIPANTS: Random sample of 28 902 working adults in the United States. MAIN OUTCOME MEASURES: Lost productive time due to common pain conditions (arthritis, back, headache, and other musculoskeletal) expressed in hours per worker per week and calculated in US dollars. RESULTS: Thirteen percent of the total workforce experienced a loss in productive time during a 2-week period due to a common pain condition. Headache was the most common (5.4%) pain condition resulting in lost productive time. It was followed by back pain (3.2%), arthritis pain (2.0%), and other musculoskeletal pain (2.0%). Workers who experienced lost productive time from a pain condition lost a mean (SE) of 4.6 (0.09) h/wk. Workers who had a headache had a mean (SE) loss in productive time of 3.5 (0.1) h/wk. Workers who reported arthritis or back pain had mean (SE) lost productive times of 5.2 (0.25) h/wk. Other common pain conditions resulted in a mean (SE) loss in productive time of 5.5 (0.22) h/wk. Lost productive time from common pain conditions among active workers costs an estimated 61.2 billion dollars per year. The majority (76.6%) of the lost productive time was explained by reduced performance while at work and not work absence. CONCLUSIONS: Pain is an inordinately common and disabling condition in the US workforce. Most of the pain-related lost productive time occurs while employees are at work and is in the form of reduced performance.

Absenteeism↗

PubMed2006

Challenges facing academic dermatology: survey data on the faculty workforce.

BACKGROUND: There is a perception among many academic dermatologists that departments of dermatology face severe challenges with recruitment and retention of faculty. In an era when evidence points to a shortage of dermatologists and residency graduates have plentiful private practice offers in almost every geographic area, some fear that academic programs will face even steeper challenges attracting and keeping enough dermatologists on staff. METHODS: To compare the practice patterns of academic dermatologists with those of the dermatology workforce in other settings, data from the American Academy of Dermatology 2002 Practice Profile Survey were analyzed (1425 respondents, 35% response rate). RESULTS: The mean age of academic dermatologists (45.6 years) was younger than that of those in other practice settings (51.9 years solo practice, 49.0 years multispecialty group), and older age cohorts were significantly less likely to be working in academics (P < .001). Academic physicians were much more likely than those in solo practice or dermatology-only groups (62.2% vs 18.3%-39.4%) to report that their institution or practice was seeking new dermatologists. The average waiting time for new patient appointments varied from a low of 31.1 days in solo practices to a high of 55.9 days in academic practices. Academic dermatologists saw 32% to 41% fewer patients per week, but spent much more time (24.1 vs 5.5-8.6 h/wk) participating in research, hospital consults, medical writing, administrative activities, and teaching than dermatologists in any other setting. LIMITATIONS: Academic dermatologists reflected a relatively small proportion of survey respondents, and may not be representative of the nation's dermatology faculty (although the percentage of academics in the survey was similar to that in the overall workforce). Possible response biases could also have affected the survey results. CONCLUSIONS: The survey results identify a number of differences between the practice patterns of academic dermatologists and their colleagues in other settings, and suggest that academic departments of dermatology may be facing unique workforce challenges.

Adult↗

PubMedDate not supplied

Health services research and the nursing workforce: access and utilization issues.

Access to personal health services is only possible if there are an adequate number and distribution of qualified nurses. However, most work on access has been conceptualized as access to physician services or particular types of settings such as hospital care, not as access to nurses. In this paper I have used the Institute of Medicine Access framework to conceptualize the relationship of the nursing workforce to several aspects of access, and evaluated both the current state of research and existing gaps. Some of the gaps identified in the research that need to be included in a health services research agenda for nursing are: (1) the effect of regional market factors (such as physician ratios and poverty), or attitudes on the supply of nurses; (2) the lack of a critical analysis of staffing and outcome research, and measures of utilization and access specific to nurses in a variety of settings; (3) the need for more and better data to evaluate nurse career patterns, nursing workforce educational capacity, and effectiveness; and (4) relevant workforce policies.

Career Mobility↗

PubMed1999

Some thoughts about the past and future of pathology workforce.

Comprehensive information on pathology workforce is currently not available. Prudent planning for pathology Graduate Medical Education (GME) requires more timely data than presently exist. In addition, we lack understanding of workforce kinetics in academic pathology which often serves as a buffer in times of surplus. Although the heads of community hospital and private laboratory groups control the majority of decisions regarding pathology workforce, a database of these decision-makers does not exist. However, information from the most recent published sources strongly suggests that a significant surplus already exists. Furthermore, this position is supported by earlier unpublished work from the 1994-1995 Conjoint Committee on Pathology Enhancement (CCOPE) surveys.

Education, Medical, Graduate↗

PubMed2002

A pre-employment programme for overseas-trained doctors entering the Australian workforce, 1997-99.

OBJECTIVES: Overseas-trained doctors (OTDs) have limited access and formal interaction with the Australian health care system prior to joining the Australian medical workforce. A pre-employment programme was designed to familiarize OTDs with the Australian health care system. METHOD: All OTDs who had passed their Australian Medical Council (AMC) exams and were applying for a pre-registration year in New South Wales were invited to participate in the voluntary, free programme. A 4-week full-time programme was developed consisting of core group teaching and a hospital attachment. The curriculum included communication, health and workplace skills; and sessions on culture shock and the role of junior doctors. A pilot programme was run in 1997. The programme was repeated in 1998 and 1999. The OTDs' confidence regarding the general duties of internship, and attitudes towards hospital workplace skills were examined. RESULTS: The 66 OTDs reported greater understanding of staff and communication issues and familiarization with the hospital environment. They reported a more realistic understanding of the role of a junior doctor, the need for separation of workplace and personal responsibilities and knowledge of pathways for future professional development. The course structure, with a focus on hospital attachments, establishment of a peer network, and workplace familiarization facilitated entry into the hospital workforce. CONCLUSION: The pre-employment programme enabled the OTDs to have a more equitable entry into the public hospital system, resulting in a more integrated, confident and functional workforce.

Australia↗

PubMed2002

The effect of renal insufficiency on workforce participation in the United States: an analysis using National Health and Nutrition Examination Survey III data.

BACKGROUND: End-stage renal disease is associated with workforce nonparticipation, but no previous study has assessed the impact of renal insufficiency on employment status from a population standpoint. METHODS: To determine whether renal insufficiency is independently associated with labor force participation, an analysis was performed using observational data from the Third National Health and Nutrition Examination Survey, which represents a cross-sectional sample of the US population. Five thousand five hundred fifty-eight subjects of the civilian noninstitutionalized US population aged 18 to 64 years provided complete information regarding key variables. A logistic regression equation with workforce participation as the dependent variable was created. Explanatory variables included age, sex, race, marital status, census region, and education, as well as the health-state indicators of general health status, presence or absence of diabetes, hypertension, stroke, congestive heart failure, myocardial infarction, and an indicator of renal function. Renal dysfunction was defined by serum creatinine values greater than 1.7 mg/dL (150 micromol/L) for women and greater than 2.0 mg/dL (180 micromol/L) for men. RESULTS: Renal dysfunction was independently associated with labor force nonparticipation, with an odds ratio of 7.94 (95% confidence interval, 1.60 to 39.43). This relationship remained statistically significant after subjects with markedly elevated serum creatinine levels were excluded. CONCLUSION: A previously unrecognized independent association between renal function and labor force participation was identified. This group of patients warrants further attention regarding identification of specific factors leading to nonemployment, potential for workforce rehabilitation, and assessment of the impact of renal insufficiency in other functional spheres.

Adolescent↗

PubMed1998

Criteria for the reintegration in the workforce of workers with musculoskeletal disorders of the upper limbs, based on preliminary practical experience.

This paper presents a preliminary study on the return to the workforce of employees with WMSDs of the upper limbs, and their reallocation to jobs with 'low exposure'. The study, which is still underway, involves a large engineering firm and includes some 100 workers affected by WMSDs. The trial involved: providing a definition of the criteria for characterizing 'accommodating' jobs (i.e. frequency of action < 20 actions/min; virtual absence of other risk factors such as force, awkward posture, inadequate pauses, etc.); effectively identifying jobs meeting such criteria (or jobs which, with minimal modifications, could be made suitable); classifying WMSD workers according to the type and severity of the disorder; matching WMSD workers with the jobs best suited to them; specific training for the workers and their supervisors; carrying out a follow-up of the return of WMSD workers to the workforce in organizational terms (i.e. the need for further modifications to equipment or procedures) and clinical terms (i.e. symptom patterns, acceptability of the condition). The preliminary results, 6-12 months after the start of the trial, are extremely encouraging, and show that when workers return to the workforce in jobs that fully meet defined criteria, a significant prevalence of 'improvements' are reported among the workers involved. The investigation will need to be extended but it already shows quite convincingly that it is possible for workers with what can be described as a 'reduced working capacity' to remain 'productive' (albeit in jobs featuring a lower exposure potential than the acceptable threshold for 'healthy' workers).

Arm↗

PubMed2005

Lost productive time associated with excess weight in the U.S. workforce.

OBJECTIVE: The objective of this study was to examine health-related lost productive time (LPT) in overweight and obese workers. METHODS: Cross-sectional study using data from a national telephone survey of the U.S. workforce. Body mass index defined normal-weight, overweight, and obese workers. LPT in hours and dollars was compared among the three groups. RESULTS: Obese workers (42.3%) were significantly (P<0.0001) more likely to report LPT in the previous 2 weeks than normal-weight (36.4%) or overweight workers (34.7%). Health status mediated the relation between obesity and LPT. Obese workers cost an estimated $42.29 billion in LPT, an excess of $11.70 billion compared with normal-weight workers. Presenteeism accounted for 67.8% of the cost. Comparatively, overweight workers were not a significant source of excess LPT. CONCLUSIONS: Reducing excess weight in the workforce and improving the health of obese workers could positively impact U.S. workforce productivity.

Absenteeism↗

PubMed1996

Managing workforce diversity--a response to skill shortages?

Explores the strategy of managing workforce diversity as a possible response to skills shortages within the UK National Health Service. Stresses that, if health care organizations truly wish to harness the diversity of their workforce, ways must be found of understanding personal motivations and creating employment opportunities which, as far as it is reasonable, meet these needs and expectations. Emphasizes that failure to adopt such an approach could alienate, possibly permanently, sectors of the potential workforce.

Cultural Diversity↗

PubMed1989

The functioning of nursing routines in the management of a transient workforce.

Project 2000 recommends supernumerary status for learner nurses. This recommendation is derived, in part, from research into the educational effects of the current organization of nurse training. However, little research appears to have been undertaken into how the current training programme influences the organization and implementation of patient care. The research from which this paper is taken, addresses this question. It demonstrates that the allocation of learners to wards gives rise to an unstable and transient workforce. Currently, ward sisters and charge nurses are expected to plan and be accountability for care given. This research suggests that nursing routines provide qualified nurses with a method for maintaining control, stability and accountability for the care given by an unqualified and everchanging workforce. It is suggested, therefore, that the promotion of individualized care in nursing requires a reduction in dependence on the transient workforce which results from including learners in the staffing establishment of hospital wards.

Humans↗

PubMed1998

Positions and training of the indigenous health workforce.

A survey of community-controlled and state health services was conducted in 1995 as part of a needs assessment for a tertiary training initiative in applied epidemiology. Information for 792 Indigenous people in health-related occupations was obtained. Mean time in the current position was 4.8 years, 75% were in designated Aboriginal positions and 44% were health workers. Of the total, 49% had a diploma or certificate, but only 3% had a bachelors degree. The latter compares with 75% of the public health workforce generally which has a bachelors degree or higher. The high proportions of health worker and designated Aboriginal positions, short tenure and low level of degree training suggest that there are a range of employment and training issues which need to be addressed if an appropriate level of Indigenous workforce participation is to be achieved and Indigenous health professionals are to have access to the same vertical and lateral employment mobility as non-Indigenous workers. In particular, there is a huge need to enhance Indigenous participation in health workforce training, and to develop strategies for certification and recognition of the wide range of non-course-based training being undertaken.

Adolescent↗

PubMed1996

Relation of spirometric function to radiographic interstitial fibrosis in two large workforces exposed to asbestos: an evaluation of the ILO profusion score.

OBJECTIVES: To analyse quantitatively the relations of spirometric lung function (forced vital capacity (FVC)) to radiographic interstitial pulmonary fibrosis (assessed by the International Labour Organisation (ILO) profusion score of small irregular opacities) in two large workforces exposed to different intensities of asbestos. These analyses consider the question whether a similar profusion score n differently exposed workers is associated with a similar effect on lung function. METHODS: Surveys of two workforces, insulators (n = 2611) and sheet metal workers (n = 1245), by the same investigators allowed comparison of the effects of the two levels of exposure to asbestos. The two groups were of similar age and had similar percentages of non-smokers and smokers. All radiographs were read by the same expert reader. RESULTS: Consistent with their less continuous and less intense exposure to asbestos, metal workers had: (a) far less frequent radiographic asbestosis (profusion score > or = 1/0, 17.5% v 59.6% for insulators): (b) less severe radiographic asbestosis (only 1.1% had scores > or = 2/1 v 13.3% of insulators); (c) a similar slope to that seen in insulators for the relation between FVC and profusion score when pleural thickening was absent; (d) less frequent pleural fibrosis (36% v 75%); and (e) less frequent restrictive impairment (23% v 33%). In both insulators and metal workers, lung function was below normal even when lung fields were normal, FVG fell with increasing profusion, it was lower in smokers and in those with pleural thickening at comparable profusion scores, and these was no difference in FVC between scores 0/1 and 1/0. CONCLUSION: The decrease in FVC with increasing profusion score in both workforces as well as the similar slopes for the relation between FVG and profusion score and the similar FVG at similar scores in the absence of pleural thickening confirm the ILO profusion score as an acceptable assessment of pulmonary fibrosis.

Adult↗

PubMed2004

Imbalance in the health workforce.

Imbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. The framework emphasizes the number and types of factors affecting health workforce imbalances, and facilitates the development of policy tools and their assessment. Moreover, to facilitate comparisons between health workforce imbalances, a typology of imbalances is proposed that differentiates between profession/specialty imbalances, geographical imbalances, institutional and services imbalances and gender imbalances.

Journal Article↗

PubMed2005

The potential impact of the next influenza pandemic on a national primary care medical workforce.

BACKGROUND: Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. METHODS: The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta) was applied to the New Zealand primary care medical workforce (i.e., general practitioners). RESULTS: At its peak (week 4) the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88%) would be lost due to illness, followed by hospitalisation (8%), and then premature death (4%). Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64%) of lost workdays would be due to illness, followed by caring for others (31%), hospitalisation (4%), and then premature death (1%). CONCLUSION: Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

Journal Article↗

PubMed2001

Human inputs: the health care workforce and medical markets.

Arrow wrote his classic article in simpler times, as those who chance upon this article forty years hence will say of today. It was a new era in science and medicine, soon to be fueled by new resources from Medicare and the National Institutes of Health. Fiscal constraint was a stranger, physicians were in short supply, and information asymmetry was pervasive. In the intervening years, Americans have become more comfortable with health care issues. Fatal illness, which was rarely discussed with patients in 1960, is now researched by them on the Internet, and greater attention is paid to patient rights. Nonetheless, concerns about quality have, if anything, increased. Indeed, it is public concern about quality that has invited governmental regulation and induced a defensive posture among medical organizations, which are rushing to establish their own instruments of quality, and it is these same public concerns that have facilitated the ability of managed care to offer itself as the guarantor of quality. However, center stage is now held by another issue: health care costs. As a result, the focus has shifted from resolving information asymmetry by enhancing quality to controlling national health expenditures by changing the size and composition of the health care workforce. Licensure, which was restrictive in 1960, is more relaxed today, thereby reducing the entry barriers for the NPC disciplines, several of which were just beginning when Arrow wrote his article. The entry of NPCs into the realm of physician's services partially counterbalances the constraints that have been placed on physician supply, although the major contributions of NPCs are skewed to the primary care end of the spectrum while the major constraints on physician supply affect specialists. The growing presence of NPCs creates a dynamic market in which practitioners in various disciplines both compete and collaborate. It is, in fact, the perfect market that Arrow reluctantly longed for, in which providers who have different levels of skill offer their services at varying prices. But consumers have little upon which to base their choices. And while many of the services offered by NPCs replace physician services at a lower price, others represent additional services, which add to aggregate spending. Arrow sought to explain how a market replete with uncertainty could function. He saw that licensure, entry rationing, and educational subsidies could work to enhance quality, but they did so at the expense of the market. The market has seen it differently and has usurped these tools for its own purposes, leaving quality to look for other sponsors. Has it done so wisely? We have yet to see how well a multidisciplinary workforce of autonomous providers will function, but both successes and failures abound. What is more apparent is how entry rationing and restrictions on educational subsidies have capped the supply of physicians and limited the production of specialists at a time when there is increasing demand for their services. Arrow identified potent tools for affecting the characteristics of the health care workforce. They now must be redirected to the needs of the future.

Economic Competition↗

PubMed2004

Twenty-year trends in regional variations in the U.S. physician workforce.

Large differences in the regional supply of physicians have challenged traditional methods of determining the "right" workforce rate. With continued growth expected in the number of U.S. physicians per capita, this study examines changes in regional variation over time to provide perspective on where future physicians are likely to locate. There was a slight reduction in workforce variation during the past twenty years as the aggregate supply per capita grew more than 50 percent. Most physicians located in regions with an already large supply. Given these persistent patterns, the population benefits of further growth in the physician workforce are uncertain.

Medically Underserved Area↗

PubMed2001

Characterization of the New Jersey lead hazard control workforce.

Individuals performing lead evaluation and abatement activities in New Jersey must complete certified training, an examination, and have a state permit card. Key demographic information was collected and summarized to describe this newly emerging lead workforce, to enhance lead training, to identify education and outreach needs, and to promote environmental justice. Summarizing these data also will assist other states implementing similar lead training and certification programs. As of June 30, 1998, the New Jersey Department of Health and Senior Services (NJDHSS) issued 2,370 permits to individuals in six disciplines. The lead workforce s average age was 38 years and 88 percent male. Most females were in the Inspector/Risk Assessor and Worker-Housing and Public Buildings (HPB) disciplines. Eighty percent of the workforce resided in New Jersey. Whites and Asians/Pacific Islanders were more educated than Hispanics or Blacks and a greater proportion of them were employed in the more skilled disciplines. Inadequate work experience may have prevented Blacks from qualifying for the more skilled disciplines; for Hispanics, there was also a language barrier. Twenty-nine percent of Workers and Supervisors had children less than six years of age residing in their household, which was higher than comparable state rates. The proportion of households with children under six years of age were similar for Black (32 percent), Hispanic (30 percent), and White (27 percent) households. The number of children less than six years of age per Black and Hispanic permittee was significantly higher than for Whites. Take-home lead issues and possible initiatives to promote minorities in the more skilled disciplines are discussed.

Journal Article↗

PubMedDate not supplied

Relationships of alcohol use, stress, avoidance coping, and other factors with mental health in a highly educated workforce.

PURPOSE: The relationships of drinking, stress, life satisfaction, coping style, and antidepressant use to mental health were examined in a highly educated workforce. DESIGN: This study used a one-time mail-out, mail-back cross-sectional survey design to examine the relationships of mental health with three kinds of stress (life events, work stress, home stress); two kinds of life satisfaction (work and home); use of avoidance coping; and antidepressant use. SETTING: This study was conducted at a large worksite in northern California in which the workforce was comprised of predominantly highly educated employees. SUBJECTS: Questionnaires were mailed to a random sample of 10% of 8567 employees, and 504 were completed and returned by participants (59%). Complete data were provided by 460 participants (53%). MEASURES: Respondents completed the Mental Health Index, the Alcohol Use Disorders Identification Test (AUDIT), and measures of coping style, work and home stress and satisfaction, stressful life events, and antidepressant use. RESULTS: Mean Mental Health Index scores were at the 32nd percentile of the U.S. population-based norms, with low percentile values associated with worse mental health. Using multiple regression analysis, the factors examined in this study were significantly related to Mental Health Index scores as the dependent variable [F(16, 443) = 27.41, p < .001, adjusted overall R2 = .48]. Poor mental health scores were significantly related to the following: age (p < .05); screening positively for current harmful or hazardous drinking (p < .05); having high levels of stress at work (p < .05) or home (p < .01); experiencing dissatisfaction with work (p < .001) or home life (p = .01); engaging in avoidance coping (p < .001); and using antidepressants (p < .001). Employees currently using antidepressants had significantly more outpatient medical and mental health visits, indicating higher health costs. Furthermore, mental health status was also significantly related to the interactions between several pairs of these variables: education and gender, age and job stress, home satisfaction and work stress, home satisfaction and avoidance coping, and home satisfaction and use of antidepressants. CONCLUSION: Mental health status was poorer on average in a highly educated workforce compared with general U.S. norms. Most of the factors that were found to be associated with poorer mental health were ones that are potentially modifiable, such as experiencing more stress and less satisfaction in work and home life and engaging in current hazardous or harmful drinking. The findings that mental health is worse among individual employees who exhibit combinations of these factors suggest that we need to better understand possible effects of these factors in the context of one another. As interpretation of these results may be limited by the single worksite that participated in this study, future research should re-examine these relationships in other worksites varying from this one in geography and demographic characteristics.

Adaptation, Psychological↗