Title: Health Workforce Trends in Nevada and Their Impact on Health Care and Public Health
1Health Workforce Trends in Nevada and Their
Impact on Health Care and Public Health
- John Packham, PhD, Tabor Griswold, MS,
- Jake Burkey, MS, and Caroline Ford, MPH
- University of Nevada School of Medicine
- Nevada Public Health Association Annual Meeting
- Henderson Nevada
- October 5, 2006
2Overview
- Forces influencing the demand for health care and
health professionals in Nevada - Physician workforce in Nevada
- Registered nurse workforce in Nevada
- Dental workforce in Nevada
- Public policy implications
- Discussion
3Primary Forces Influencing the Demand for Health
Care and Health Professionals in Nevada
- Population growth
- Population aging and diversification
- Economic growth and the ability of employers to
subsidize health insurance coverage for workers - Public-sector reimbursement of health care
4Other Factors Affecting the Demand for Health
Care and Health Professionals in Nevada
- Health care needs (versus demand), i.e., Nevadas
unique population health profile - Health information advances and technological
change - Licensing, regulation, and accreditation
- State and federal political environment
5Physician Workforce in Nevada
6Physician Workforce in Nevada
- Analysis of the Nevada section of the AMA
Masterfile - Data from the AMAs Physician Characteristics and
Distribution in the US, 2006 Edition - Selected data from the Nevada State Board of
Medical Examiners and other secondary sources
7Physician Workforce in Nevada 2006
- 3,750 allopathic physicians in Nevada with an
active license in 2006 (MDs) - 400 osteopathic physicians in Nevada with an
active license in 2006 (DOs) - Total of 4,150 physicians who reside in Nevada
with an active license and 148 with an inactive
license
8Physician Workforce in Nevada 2006
- Average age of Nevada physicians with an active
license is 48.4 years - Average age of MDs is 48.6 and DOs is 46.6
- Gender distribution 21.9 of all physicians are
women, 78.1 are men - Percent distribution of women is greatest among
physicians aged 30-34 (40.5) and lowest among
those aged 70-74 (5.8)
9Physician Workforce in Nevada 2006
- 95.9 of actively licensed physicians listed
direct patient care as their primary professional
activity versus 4.1 primarily working in medical
teaching/research, or non-patient care - 40.9 self identify as primary care specialists
(FM, IM, GP, Peds, Ob/Gyn) versus 59.1 as
specialty-care physicians - Primary care MDs 1,487 (39.7)
- Primary care DOs 209 (52.3)
10Physician Workforce in Nevada 2006
- Geographic distribution of physicians
- Urban south 2,839 (68.4)
- Urban north 1,150 (27.7)
- Rural and frontier 134 (3.2)
- Not classified 27 (0.7)
- Population distribution
- Urban south 1,892,391 (71.9)
- Urban north 519,326 (19.7)
- Rural and frontier 219,340 (8.3)
- Nevada Total 2,631,057
11Physician Workforce in Nevada 2006
12Physician Workforce in Nevada 2006
13Physician Workforce in Nevada 2006
- Location of Medical School
- Nevada 378 (9.1)
- Other U.S. State 2,722 (65.6)
- Other Country 1,050 (25.3)
- Location of Medical Residency Training
- Nevada 386 (9.3)
- Other U.S. State 3,539 (85.3)
- Other Country 15 (0.4)
- Missing Data 210 (5.1)
14Physician-Population Ratios in the US and Nevada
1975 to 2004
Source American Medical Association (2006)
15Population per One Physician Ratios in the US and
Nevada 1975 to 2004
Source American Medical Association (2006)
16Maintaining Existing Physician-Population Ratios
in Nevada 2005 to 2015
- To maintain a ratio of 211 physicians (active,
inactive, and retired) per 100,000 population - 5,917 will be needed in 2010 or 983 more than the
total 4,934 licensed to practice in 2004 - 6,596 will be needed in 2015 or 1,662 more than
the total 4,934 licensed to practice in 2004
17What We Do and Dont Know About the Physician
Workforce in Nevada in 2006
- Wide-range of socio-demographic, employment, and
specialty characteristics of practicing and
non-practicing physicians - Retirement and future employment preferences and
plans of physicians - Accurate physician supply and demand estimates
and projections
18Registered NurseWorkforce in Nevada
19Purpose of the 2005 Survey of Licensed Registered
Nurses in Nevada
- General RN workforce characteristics including
- Education and certification
- Employment and job characteristics
- Social and demographic characteristics
- Specific nursing and health care issues in Nevada
including - Job and career satisfaction
- Reasons for not providing direct patient care
- Capacity to respond to bioterrorist attacks
20Licensed RNs in Nevada December 1, 2004
- Total 20,494 Licensed RNs on 12.1.04
- Out of State 5,636 (27.5 of Total)
- Nevada Total 14,858 (72.5)
- Southern Nevada 10,159 (68.4)
- Northern Nevada 3,837 (25.8)
- Rural and Frontier Nevada 862 (5.8)
21Estimated Number of RNs in Nevada 2005
- Full- Part-time RNs Employed in Nursing
- Nevada 13,198 (88.8 of licensed RNs)
- Southern Nevada 9,061 (89.2)
- Northern Nevada 3,438 (89.6)
- Rural and Frontier Nevada 699 (81.0)
22Age and Gender Distribution of RNs in Nevada
2005
- Mean RN Age
- Nevada 49.1 Years
- Southern Nevada 48.5 Years
- Northern Nevada 50.1 Years
- Rural and Frontier Nevada 49.4 Years
- 94.4 of RNs are female, 5.6 male, and that
distribution is similar across regions
23Highest Level of Nursing Education of RNs in
Nevada 2005
24Hispanic or Latino Heritage and Ability of RNs to
Speak Spanish 2005
25Racial Background of RNs in Nevadaby Region
2005
26Employment Setting of Principal Position of RNs
in Nevada 2005
27Q.17. Satisfaction with Nursing as a Career
Nevada
28Q.18. Satisfaction with Current Job Nevada
29Q.20. Willingness to Provide Patient Care During
Mass Casualty Events
- 75.2 Natural Disaster
- 56.3 Explosive Event
- 48.5 Chemical Incident
- 46.5 Biologic Incident
- 43.7 Contagious Epidemic
- 40.8 Radiologic Incident
- 22.1 Not able to provide care in a mass
casualty event
30Q.21. Time Able to Commit During a Disaster or
Mass Casualty Event in Another Community
- 24.0 1-3 Weeks
- 23.7 1 Week
- 11.8 1-2 Months
- 4.5 More than 6 Months
- 1.6 6 Months
- 34.2 Not able to commit time during a disaster
or mass casualty event
31Q.22. Factors Negatively Influencing Ability to
Provide Care During a Disaster or Mass Casualty
Event
- 43.1 Financial issues
- 33.2 Commuting distances or issues
- 31.9 Family members who are affected by the
incident - 29.7 Personal safety concerns
- 24.1 Child care issues
32Q.22. Factors Negatively Influencing Ability to
Provide Care During a Disaster or Mass Casualty
Event (continued)
- 22.9 Rate of spread of contagious agent
- 17.4 Other
- 15.9 Injury or death to rescue workers
- 6.7 Nothing would stop me
33Q.23. Percent of RNs Having Knowledge of How to
Treat Casualties Involving
34Q.23. Percent of RNs Having Knowledge of How to
Treat Casualties Involving
35What We Do and Dont Know About the Nursing
Workforce in Nevada in 2006
- This survey established baseline data on a
wide-range of socio-demographic, employment, and
specialty characteristics of the RN population - Continued reliance on nursing graduates from
other states - Education and recruitment for future nurses to
fill the changing model of and demand for nurses - Accurate nursing supply and demand estimates and
projections
36Dental Workforce in Nevada
37Purpose of the Nevada Dental Workforce Study 2006
- General dental workforce characteristics
including - Education and training of dentists and hygienists
- Employment and job characteristics
- Social and demographic characteristics
- Specific dental workforce issues in Nevada
including - Job satisfaction
- Career and retirement plans
- Treatment of patients with limited access to care
38Nevada Dental Workforce Study 2006
- June and July
- Development of questionnaires with advisory
committee - August and September
- Pilot and finalize questionnaires, develop
on-line survey - October
- Distribute questionnaires, begin data collection
- November December
- Data aggregation and data analysis
- January February
- Final report preparation and release
39Public Policy Implications and Discussion
40Health Workforce Implications
- Education and Training Programs
- Expansion, maintenance, or contraction
- Health Services Impacts
- Access to care, safety net providers, diffusion
- Licensing and Regulatory Inferences
- Waivers or relaxing of standards expansion of
protocols new categories of professionals - Health Policy
- Nevada System of Higher Education Legislative
Health Care Committee Governors Medical
Education, Research and Training
41Health Policy
- Nevada System of Higher Education
- Medical Education Council of Nevada
- MECON support-Governors Accountability Task
Force, Rural Health Strategic Plan - UNSOM Office for Health Professions Research and
Policy - Health Sciences Center-enhancement MECON, Family
Practice Rural Training Track Program, AHEC,
Nevada Health Service Corps - Health Workforce Agency request from Legislative
Committee - Health Professions Training expansions e.g.
physicians, nurses
42Health Policy
- Legislative Committee on Health Care
- Health Planning and Development Agency-expansion
within the Health Division - Health Workforce Planning-NSHE
- Proposal to regulate health professions
- Reimbursement enhancements-proposal through
Nevada Medicaid - Recruitment incentives for rural service-proposal
through DHHS
43Health Policy
- Governors Medical Education, Research and
Training Commission (Draft-not final) - Establish Nevada Health Coordinating Committee
- Support integrated expansion of healthcare
professional education - Increase recruitment and retention
- Create state-wide biomedical/health research
44Health Policy
- Support student mentoring and internships
- Develop linkages between service providers
agencies with training programs - Collaborate on health careers development with
Area Health Education Center programs and others - Advocate for expansion of training and practice
opportunity programs
45Additional Information
- John Packham, PhD
- University of Nevada School of Medicine
- (775) 784-1235
- jpackham_at_medicine.nevada.edu
- http//www.unr.edu/med/dept/CEHSO/pubs.html