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PubMed2006

The American Association for Pediatric Ophthalmology and Strabismus workforce distribution project.

PURPOSE: To describe data sources and functional utility of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) workforce database and associated map files. METHODS: Population data from the 2000 U.S. Census and current listings from the AAPOS and American Academy of Ophthalmology (AAO) databases were organized to demonstrate and analyze practitioner-to-population relationships for metropolitan statistical areas nationwide. An interactive map was developed to provide an intuitive graphical display of the data. RESULTS: A total of 749 active AAPOS members were distributed in 154 of 280 defined metropolitan statistical areas. Within these areas, a 0- to 20-year age subgroup varied from 17.8% to 42.6%, with an average of 30.4%. The AAPOS member-to-million-person ratio varied from 1.3 to 27, with higher numbers generally representing regions with population bases inadequately defined by Census Bureau statistical area definitions. Ratios for a majority of larger, better-defined areas ranged from 3 to 4 AAPOS members per million persons. Sizable areas with no AAPOS member presence were identified and tabulated. AAO members with a specified pediatric practice focus who were not AAPOS members were identified in 103 areas, possibly influencing patient choices and practitioner referrals for these regions. CONCLUSIONS: The AAPOS workforce database and related interactive map display practitioner and population data that may assist physicians and planners in targeting practice development and identifying potentially underserved areas.

Databases, Factual↗

PubMed2005

Workforce projections for emergency medicine in Puerto Rico: a five-year follow-up of an evident demand.

In this study, two mathematical equations were used to calculate and establish the actual Emergency Medicine workforce needed in Puerto Rico (PR) and project the time frame to meet the actual demand. 1) Supply equals the number of existing Emergency Physicians (EPs) plus residency-trained graduates in EM per year minus the annual attrition rate (3%); and 2) Demand equals six (6) full time equivalent positions per Emergency Department (ED) times the total number of EDs in PR. Under both scenarios tested, the significant EP shortage in PR will continue until 2044. The actual calculated shortage is 287 EPs. There is an actual significant shortage in the Puerto Rico EP workforce. It will take a long time to make leaders understand the positive impact of having residency-trained EPs in every ED, on quality patient care and the whole health care system.

Emergency Medicine↗

PubMed2006

Predicting the impact of Medicare Part D implementation on the pharmacy workforce.

BACKGROUND: There is currently a shortage of pharmacist manpower, and it is expected to continue into the near future. It is also likely that the implementation of Medicare Part D will further aggravate the shortage by increasing demand, but it is not clear how much impact it will have. OBJECTIVE: The purpose of this study was to estimate the impact that the new Medicare drug benefit program will have on pharmacy workforce demand. METHODS: Analysis was conducted using forecasting techniques, which combines traditional statistical theory with both quantitative and qualitative methods. The Aggregated Demand Index (ADI) was designated as the dependent variable. A number of independent variables were selected for their potential to affect the workforce, demand for prescriptions or clinical services, and patient population. Data for the identified variables were collected from a variety of sources. Supply and demand data were analyzed at a national level. RESULTS: Both historical and univariate forecasts indicated that the demand for pharmacists will continue to exceed the supply of pharmacists. The ADI ratio of pharmacist demand-to-supply has recently leveled off which means that demand and supply are in an equilibrium that falls to the demand side. Consequently, the Medicare Modernization Act (MMA) is not predicted to produce a dramatic increase in prescription volume, which would change the current demand for pharmacists. Multivariate forecasting models were not robust primarily due to the lack of precise predictor variables. CONCLUSIONS: Despite the reliance on preliminary univariate forecasts and imprecise predictor variables, it appears that the increased use of prescriptions due to the MMA Part D will have minimal impact on pharmacist demand.

Humans↗

PubMed2003

Great expectations: the 21st century health workforce.

Health workforce studies have mostly predicted an oversupply of physicians, a shortage of primary care doctors, and an excess of specialists. As the target date of many of these studies is now passed, it is clear that we are evolving into a shortage of physicians, especially specialists, and that primary care will increasingly be done by nonphysician clinicians. The "knowledge society" requires a different workforce than that predicted by most health planners.

Delivery of Health Care↗

PubMed1996

Physical medicine and rehabilitation workforce study: the supply of and demand for physiatrists.

OBJECTIVE: Analysis, results, and implications of a supply and demand workforce model for physical medicine and rehabilitation. Explicit issues addressed include: (1) the supply implications of maintaining current (1994-1995) output of physiatrists from residency programs; (2) the implications of continued growth in managed care on the demand for the services of physiatrists; (3) likely future supply and demand conditions; and (4) strategies to adapt to future conditions. DESIGN: A workforce model of the supply and demand for physiatrists was developed. Parameters of the model are estimated using econometric models and by applying the judgments of a consensus panel. The model evaluated several different scenarios regarding managed care growth, competition from other providers and other factors. RESULTS: Based on the analysis, physiatrists will continue to be in excess demand through the year 2000. More aggressive growth in managed care can affect this result. CONCLUSIONS: Based on an overall assessment of supply and demand conditions, and under the assumption that the supply of new entrants each year remains in the range of 1994-1995 levels, demand for physiatrists will continue to exceed supply, on average, through the year 2000. Excess supply has, and will, emerge in selected geographic areas. If the profession is successful in informing the market regarding the advantages of physiatry, the profession can continue to grow without experiencing excess supply, in the aggregate, for the foreseeable future.

Forecasting↗

PubMed2003

The toughest job you'll ever love: a Pacific Northwest Treatment Workforce Survey.

The training, recruitment, and retention of the most qualified professionals for the substance abuse treatment workforce is a crucial underlying strategy in the improvement of client care. Conducted in the year 2000, this survey of substance abuse treatment agency directors and clinical staff in the Pacific Northwest of the United States provides the first empirical estimates of issues surrounding these goals and points to the need for more aggressive strategies if a quality workforce is to be maintained and improved. Results of the survey indicate that there is an average of 25% turnover per year among treatment agency staff, and that the vast majority of this turnover is voluntary and stays within the treatment profession. Agency management and direct service staff differ in their perceptions of the recruitment and retention approaches currently in place in their agencies.

Data Collection↗

PubMed2003

The workforce of professionals complementary to dentistry in the general dental services: a survey of general dental practices in the South West.

OBJECTIVE: To describe the working patterns, training experiences, estimated size, and future training needs of the workforce of professionals complementary to dentistry in the general dental service in an English region. METHODS: Postal questionnaire of NHS dental practices in the South West of England. RESULTS: The response rate was 65%. There was an average of two whole time equivalent (wte) dentists working per practice. Dentists work a mean 0.8 wte per practice. Sixty per cent of practice time is NHS. Vacancies existed for 120 dentists (98 wte) with reported difficulties in recruitment. There was an average of 1.25 wte dental nurses per dentist with 44% of nurses working part-time. A quarter of nurses' time is on non-clinical duties. The turnover rate for nurses was between 13% and 26%, with recruitment difficulties. Approximately 50% of nurses do not have a professional qualification. There is variation between health authorities in proportions of qualified nurses. Hygienists are employed in 72% of practices, but only 20% of their work is NHS. Dentists have favourable attitudes to an expansion in the employment and training of professionals complementary to dentistry. CONCLUSIONS: There are problems with recruitment and retention of all categories of the dental workforce in the GDS, particularly in rural areas. There is a large unmet need for pre- and post-qualification training for professionals complementary to dentistry compounded by marked inequalities in access to training.

Administrative Personnel↗

PubMed2003

The neuroanaesthesia workforce in Great Britain and Ireland.

A survey of the 36 units that provide a neuroanaesthesia service in Great Britain and Ireland was conducted. It shows the variation in the type of hospital, the number of whole-time equivalent neuroanaesthetists, the number of operating sessions and the number of neurosurgical beds per million of the catchment population of each unit. On-call commitment and arrangements for managing long cases are described. Current problems pertaining to neuroanaesthetic practice are mentioned. This survey will provide a basis for the planning of future neuroanaesthetic services, as the potential of expansion of neurosurgery and neuroradiology is realised. However, it is difficult to make accurate projections and hence advise on future workforce requirements in a climate of changing service delivery. Attention should be given to a number of workforce issues highlighted in this survey if recruitment into neuroanaesthesia is to be encouraged.

Anesthesia Department, Hospital↗

PubMed1999

The 'greying' of the United Kingdom nursing workforce: implications for employment policy and practice.

One in five nurses on the United Kingdom (UK) professional register is aged 50 years or older. Over the next few years, the profession will lose, through retirement, many of its most experienced practitioners. The significance for policy makers and for employers of this age-shift is two-fold. Firstly it is clear that greater numbers of nurses and midwives are reaching, or soon will reach, potential retirement age. Secondly many more nurses are now reaching their middle years and they are likely to have different requirements and attitudes to nursing work. This paper examines the employment policy and practice of the ageing of the UK nursing population. The paper examines data from official sources, and information from attitudinal surveys and case studies with employing organizations to assess the major effects of the ageing of the nursing workforce. Key findings are that the age profile of those nurses working in the National Health Service appears to be 'younger' than that of the total population, with the age profile of nurses working in nursing homes and as practice nurses being older than that of the NHS nursing workforce. However, the overall age profile of NHS nurses masks considerable variation between specialties and trusts, and the 'pool' of potential nurse returners from which the NHS and other employers attempts to recruit, is declining in numbers, as it too ages. Other major issues requiring policy attention are the provision of appropriate flexible hours to older nurses who have caring responsibilities, improving access to continuing professional development, and reducing pension provision inflexibility.

Adult↗

PubMed2000

Scoping the Australian mental health nursing workforce.

This is the second of four articles on the Scoping Study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on overlooked issues in planning the mental health nursing workforce. Whereas it is acknowledged that there are problems in the supply of mental health nurses, it is argued that equal attention needs to be given to addressing the working conditions and rewards of mental health nurses.

Australia↗

PubMed2002

2002 Australian radiology workforce report.

This paper describes the current status of radiologist provision in Australia, and explores issues relating to its current adequacy, as well as analysing projections of supply and requirements, and their balancing. Data are drawn from several sources including the results of the Royal Australian and New Zealand College of Radiologists Workforce Survey 2000, and the report of the Australian Medical Workforce Advisory Committee Radiology Working Party 2001. The main conclusions to be drawn are that: (i) there is a current shortfall of radiologist supply in Australia; (ii) future requirements (taking all factors into consideration) are expected to grow at a greater rate than projected supply (based on the status quo); and (iii) supply of radiologists should therefore be increased. These conclusions are roughly in line with those from other countries, such as the UK, Canada and USA. Radiologists practising in Australia also appear to have relatively high productivity, including by some international comparisons. These findings are presented in the context of current issues in Australian medical imaging, including provider consolidation and corporatization, globalization and funding.

Adult↗

PubMed2000

The workforce in otolaryngology-head and neck surgery: moving into the next millennium.

OBJECTIVE: The goal was to examine the current scope of otolaryngologists' practices, their geographic distribution, and the roles otolaryngologists and other specialists play in caring for patients with otolaryngic and related conditions of the head and neck. STUDY DESIGN: A large national survey and administrative claims databases were examined to develop practice profiles and compile a physician supply for otolaryngology. A focus group of otolaryngologists provided information to model future scenarios. RESULTS: The current and predicted workforce supply and demographics are at a satisfactory level and are decreasing as a proportion of the increasing population. Empiric data analysis supports the diverse nature of an otolaryngologist's practice and the unique role for otolaryngologists that is not shared by many other providers. Together with the focus group results, the study points to areas for which more background and training are warranted. CONCLUSIONS: This study represents a first step in a process to form coherent workforce recommendations for the field of otolaryngology.

Adult↗

PubMed2001

A critical review of rural medical workforce retention in Australia.

The problem of how best to recruit and retain doctors in rural and remote communities has led governments to adopt a range of medical workforce incentives, including retention grants. A comprehensive literature survey suggests that medical workforce retention has been poorly distinguished from other supply issues such as recruitment, and that its determinants and the process leading to retention are poorly understood. Such a knowledge gap is likely to limit the effectiveness of retention incentives. This article reports the results of this literature review, and advances a conceptual framework as the basis for ongoing research and evaluating how best to deliver effective retention interventions.

Australia↗

PubMed2002

Managing the healthcare workforce: cost reduction or innovation.

Labour costs are the largest proportion of total costs in the health industry in developed countries and are a target in health sectory reform. The Kennett government in Victoria introduced policies based on competition and cost reduction and the decentralisation of industrial relations through enterprise bargaining. These policies directly impacted on the health workforce leading to work intensification, labour shortages and poor morale. The Bracks government has since returned to centralisation. This paper argues that it is time for a more innovative approach to health workforce management based on recognising staff as an asset rather than a cost.

Capitalism↗

PubMed2002

Dietitians in New South Wales: workforce trends 1984-2000.

Complete surveys of the dietetic workforce in NSW were conducted in 1984 and 1991 and have now been updated with a new survey in 2000. In the nine years since 1991, the total active workforce grew by 48%. Although there were significant improvements in the ratios of hospital dietitians per 100 acute beds (from 0.88 to 1.08) and dietitians per million population (from 69.7 to 96.5), the supply of dietitians does not yet reach recommended levels, especially in rural areas. Other trends were significant increases in the proportion of dietitians employed outside hospitals (to 38% in 2000) and in non-clinical work (50% in 2000), and declines in the number of technical support staff for dietitians.

Allied Health Personnel↗

PubMed2005

Future of family medicine workforce in the United States.

In response to the Future of Family Medicine Leadership Committee's recommendations(1) The Ohio State University Department of Family Medicine convened 10 faculty development sessions covering the following strategic objectives: (1) Promoting a Sufficient Family Medicine Workforce, (2) the Role of Family Medicine in Academic Health Centers, (3)The New Model of Family Medicine, (4) Electronic Medical Records, (5) Family Medicine Education, (6) Lifelong Learning, (7) Enhancing the Science of Medicine, (8) Quality of Care, (9) Communications, and (10) Leadership and Advocacy. The focus of this editorial is on initiatives and programs to promote a sufficient family medicine workforce. In comparison to other industrialized countries, the United States ranked lowest in primary care functions and lowest in health care outcomes, but highest in health care expenditures. Despite this fact, the trend for United States medical school graduates to select subspecialty careers continues upward. Through collaboration and advocacy, we can all ensure a continued enthusiasm for the selection and retention of family medicine as a career.

Career Choice↗

PubMed2002

Consultant rheumatology workforce in the UK: changing patterns of provision 1997-2001.

OBJECTIVES: To summarize the changes in rheumatology provision and working practice that have occurred on the basis of the results of the 1997, 1999 and 2001 surveys carried out to update the British Society for Rheumatology/Arthritis Research Campaign Rheumatology Workforce Register. METHODS: The Workforce Register includes all consultant rheumatologists in the UK who do at least one NHS clinical session per week. Questionnaires were sent to all consultants on the register at the beginning of 1997, 1999 and 2001. The questionnaires asked about clinical commitments and workload. RESULTS: The response rates for 1997, 1999 and 2001 surveys were 85, 86 and 92% respectively. Scotland, Wales and Northern Ireland all had fewer consultant rheumatologists per capita than any English region. Within England, the London region had 60% more rheumatologists per capita than any other English region. CONCLUSION: There are ongoing inequalities in the provision of rheumatology, especially between London and Scotland, Wales and Northern Ireland.

Consultants↗

PubMed2003

Analysis of the nursing workforce crisis: a call to action.

In our integrative review of reports on the health care workforce shortage, we examined 15 reports that focused primarily on nursing and were conducted by various stakeholders. We studied these reports objectively, identifying problems and solutions as described by the authors, which we then categorized by theme. We found problems at both the national and institutional levels and noted that the reports contained similar problem and solution "themes." Yet we also found gaps between these-some problems had no solutions and some solutions didn't address any of the suggested problems. Gaps occurred among problems and solutions listed in the following theme categories: demand, health care economics, workforce planning, research and data support, and technology. Despite the urgent need, we still lack a national strategy designed to avert the nursing shortage. This review may provide a foundation for such a plan.We present the results of our analysis and our recommendations to the federal government and national organizations, to institutions, and to nurses. These recommendations don't provide a comprehensive strategy for averting the nursing shortage, but they do offer a basis upon which one may be created.

Health Planning↗