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Forecasting the nursing workforce in a dynamic health care market.

The ability to discern the interacting factors that affect supply and demand for nurses could help nurse educators and nurse leaders allocate resources to meet these needs. Forecasting models must take into account the interactions of three crucial groups of health care providers--physicians, nurse practitioners, and physician's assistants. Buerhaus has noted that market size, wages, preferences for nursing services, and availability of substitutes influence the demand for nursing services. Changes in nurse supply resulting from Medicare reimbursement for nursing services have not been studied, though it could safely be projected that such reimbursement will increase nurse supply. Nurses with baccalaureate degrees and advanced practice preparation will be in the greatest demand in ambulatory care, managed care, public health, and home care settings, raising concerns again that the educational mix is in need of adjustment upwards.

Delivery of Health Care↗
PubMed2006

Returning to work with HIV/AIDS: a qualitative study.

In addition to being an outcome, workforce reentry is a process: People with HIV/AIDS attempting to go back to work must make initial decisions to engage in such an attempt, they then must go through a series of steps that may include re-education or retraining, job searches, résumé development, and other activities. Sustaining employment, in turn, entails its own set of activities. People attempting workforce reentry may also experience barriers on their journeys back to work, they may employ certain strengths to reach their goals, and they may use resources to facilitate preparation for work. Few studies have attempted to study this process. This study was designed to provide an initial attempt to study the process of workforce reentry. Abstracted information from the progress notes of 104 people with HIV/AIDS attempting workforce reentry was qualitatively analyzed using a grounded theory approach to identify themes. Three major themes emerged with reliability: Barriers to workforce reentry, staff-identified strengths, and resources used in workforce-reentry efforts. Although none predicted successful workforce reentry, participants in the study experienced substantial barriers in their workforce-reentry efforts, staff identified significant strengths, and participants used appropriate resources in their efforts to go back to work. Implications for workforce-reentry programs for people with HIV/AIDS are discussed.

Adult↗
PubMedDate not supplied

Diversity in general surgery: a period of progress.

OBJECTIVE: Although 1996 to 2002 was a period of declining interest in general surgery (GS) among U.S. medical students (USS), most categorical general surgery (C-GS) training positions offered in the National Residency Matching Program (NRMP) continued to fill. We measured the impact of the decreasing U.S. student applicant volume on C-GS match outcomes and GS resident workforce composition over this time period. DESIGN: Match outcomes were analyzed for 7 applicant categories. Subsequent GS resident workforce compositions were analyzed for proportions of U.S. allopathic medical school graduates (USG), osteopathic medical graduates (OMG), Canadian MG (CMG), foreign MG (FMG), female physicians, and African-American physicians. Mantel-Haenzel chi-square tests measured trends in match percentages, C-GS positions filled, and GS workforce composition. All p-values are 2-sided. RESULTS: Increasing match percentages for USS applicants (p < 0.0001) and USG (p = 0.001), with a decreasing percentage of C-GS positions filled by these applicants (p < 0.0001), were from declining applicant volumes. Increasing match percentage for non-U.S. allopathic medical applicants reflected increases in both applicant volumes and matched applicants, with an increasing percentage of C-GS positions filled by these applicants (p < 0.0001). The subsequent resident workforce included increasing proportions of FMGs and OMGs (each p < 0.001); proportions of USG MDs and CMGs decreased (p < 0.0001 and p < 0.02, respectively). Concurrently, there were increasing numbers and proportions of female physicians (p < 0.0001) and African-American physicians (p < 0.0001) in the general surgery resident workforce. CONCLUSIONS: Declining interest among U.S. students in GS has resulted in a workforce comprised of residents from a broad range of educational backgrounds, but also it has provided an opportunity for progress toward achievement of a GS resident physician workforce more equitably representative of the racial and gender composition of our society at large.

Adult↗