Workforce andGlobal Health

H Edu 5100

Workforce

Hospital employees # of occupations/professions Growth of health care employment

Distribution of Health Care Employment by Settings

Setting % of Total

Hospitals 55.3%

Nursing and personal care facilities 17.2%

MD offices and clinics 16.5%

Dental offices and clinics 6%

Home health care 5%

Turnover - HospitalsTurnover - Hospitals

Overall = Overall = 17.58 %17.58 % Turnover by ageTurnover by age

– 29 or younger =29 or younger = 23.50 %23.50 %– 30-39 =30-39 = 13.96 %13.96 %– 40-49 =40-49 = 11.46 %11.46 %– 50 and older =50 and older = 6.86 % 6.86 %

Turnover – Hospitals Turnover – Hospitals by size and typeby size and type

0 - 100 beds = 0 - 100 beds = 16.97 %16.97 % 101 - 200 beds =101 - 200 beds = 17.22 %17.22 % 201 - 300 beds =201 - 300 beds = 20.61 %20.61 % Urban =Urban = 18.93 %18.93 % Rural =Rural = 16.99 %16.99 %

LPNsLPNs

Tenure = Tenure = 5.59 years5.59 years Openings = 3.82Openings = 3.82 Age = Age = 38.6238.62 18-24 = 18-24 = 6.77 6.77

individualsindividuals 50+ = 50+ = 4.23 4.23

individualsindividuals

RNsRNs

Tenure =Tenure =9.00 years9.00 years Openings =Openings = 23.1223.12 Age =Age = 40.2640.26 18-24 =18-24 = 29.00 29.00

individualsindividuals 50+ =50+ = 52.67 52.67

individualsindividuals

Radiologic Radiologic TechnologistsTechnologists

Tenure = Tenure = 7.317.31 Openings =Openings = 1.401.40 Age =Age = 35.6635.66 18-24 =18-24 = 2.422.42 50+ =50+ = 1.921.92

Physical TherapistsPhysical Therapists

Tenure =Tenure =5.09 years5.09 years Openings =Openings = 0.330.33 Age =Age = 35.44 35.44 18-24 =18-24 = 0.23 individuals0.23 individuals 50+ =50+ = 0.62 0.62

individualsindividuals

PharmacistsPharmacists

Tenure =Tenure =9.10 years9.10 years Openings =Openings = 0.860.86 Age =Age = 39.1139.11 18-24 =18-24 = 0.40 individuals0.40 individuals 50+ =50+ = 2.20 2.20

individualsindividuals

The Demand…The Demand…

RNsRNs

23 per Utah hospital = 1,000 or 23 per Utah hospital = 1,000 or soso

Nurse executives report similar Nurse executives report similar numbersnumbers

Utah Health Care Association Utah Health Care Association reports a 24% vacancy in LTCreports a 24% vacancy in LTC

75% of hospitals nationwide 75% of hospitals nationwide report difficulty hiring RNsreport difficulty hiring RNs (AHA (AHA

TrendWatch, June 2001)TrendWatch, June 2001)

PharmacistsPharmacists

40 openings right now in 40 openings right now in hospitals.hospitals.

Consider retail pharmacyConsider retail pharmacy 21% vacancy rate nationwide 21% vacancy rate nationwide (AHA (AHA

Special Workforce Survey, June 2001)Special Workforce Survey, June 2001)

50% of hospitals nationwide 50% of hospitals nationwide report difficulty hiring report difficulty hiring pharmacistspharmacists (AHA TrendWatch, June 2001)(AHA TrendWatch, June 2001)

The Supply…The Supply…

Current Numbers Current Numbers (RNs)(RNs)

Total licensed RNs =Total licensed RNs =17,56617,566 Total Working =Total Working = 13,25713,257 Difference =Difference = 4,309 4,309

(Utah Medical Education Council, Feb 2002)

Higher Education Higher Education (RNs)(RNs)

Undergrad applicants = 1,400Undergrad applicants = 1,400 Undergrad admissions = 760Undergrad admissions = 760 Undergrad graduates = 615Undergrad graduates = 615

(2000-01 academic year)

Higher Education Higher Education Annual Utah GraduatesAnnual Utah Graduates

Respiratory Therapists = 50Respiratory Therapists = 50 Clinical Laboratory = 35Clinical Laboratory = 35 Radiologic Technologists = 85Radiologic Technologists = 85 Physical Therapists = 36Physical Therapists = 36 Pharmacists = 40Pharmacists = 40

Demand and SupplyDemand and Supply

948

615

0

100

200

300

400

500

600

700

800

900

1000

Hospital Openings Graduates

Registered Nurses

67

50

0

10

20

30

40

50

60

70

Hospital Openings Graduates

Respiratory Therapists

Demand and SupplyDemand and Supply

Demand and SupplyDemand and Supply

131

75

0

20

40

60

80

100

120

140

Hospital Openings Graduates

Radiologic Sciences

ConcernsConcerns

Aging workforceAging workforce Aging population = more Aging population = more

servicesservices Aging facultyAging faculty

ConcernsConcerns

2% of freshmen nationwide 2% of freshmen nationwide indicate nursing as a majorindicate nursing as a major

Number of pharmacy Number of pharmacy graduates has decreasedgraduates has decreased

Enrollment and graduates do Enrollment and graduates do not keep pace with demandnot keep pace with demand

Counting the workforce

Body count FTEs Paychecks

Credentialing

Why? Limitations Procedures

LicensureCertificationRegistration

Nursing

History Levels

PNRNADN/NP

Licensing

Medicine

# of schools Men vs. Women Internship/Residency Fellowship Primary Care

Other health workers

Dental Podiatry Chiropractors Optometrists

Allied health personnel

Pharmacists Clinical Lab Sciences Physical Therapy Radiologic Sciences Respiratory Therapy

Current Issues

Shortages California mandates

Global Health

Comparative Health Systems (pg. 112)

Health System

Private Pluralistic National health insurance

National health service

Socialized health service

General definition

Health care as item of personal consumption

Health care as predominantly a consumer good or service

Health care as an insured, guaranteed consumer good or service

Health care as a state-supported consumer good or service

Health care as a state-provided public service

Position of the physician

Solo entrepreneur

Solo entrepreneur and member of variety of groups, organizations

Solo entrepreneur and member of medical organizations

Solo entrepreneur and member of medical organizations

State employee and member of medical organizations

Professional associations

Powerful Very strong Strong Fairly strong Weak or nonexistent

Ownership of facilities

Private Private and public

Private and public

Mostly public Entirely public

Economic transfers

Direct Direct and indirect

Mostly indirect Indirect Entirely indirect

Prototypes U.S., Western Europe

U.S. in 20th century

Sweden, France, Canada

Great Britain Soviet Union in 20th century

Statistics

5 Billion people Distribution

U.S. = 5% of population, 40% of budgetChina = >20% of population, <1% of budget

Does more spending = better health?

Economist categorization

High income = $10,000 per capita Medium income = $1,000-$7,500 Low income = < $1,000

International Trade

Only a tiny fraction Products People and ideas