Health Workforce Trends in Nevada and Their Impact on Health Care and Public Health - PowerPoint PPT Presentation

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Health Workforce Trends in Nevada and Their Impact on Health Care and Public Health

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John Packham, PhD, Tabor Griswold, MS, Jake Burkey, MS, and Caroline Ford, MPH ... Forces influencing the demand for health care and health professionals in Nevada ... – PowerPoint PPT presentation

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Title: Health Workforce Trends in Nevada and Their Impact on Health Care and Public Health


1
Health 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

2
Overview
  • 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

3
Primary 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

4
Other 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

5
Physician Workforce in Nevada
6
Physician 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

7
Physician 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

8
Physician 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)

9
Physician 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)

10
Physician 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

11
Physician Workforce in Nevada 2006
12
Physician Workforce in Nevada 2006
13
Physician 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)

14
Physician-Population Ratios in the US and Nevada
1975 to 2004
Source American Medical Association (2006)
15
Population per One Physician Ratios in the US and
Nevada 1975 to 2004
Source American Medical Association (2006)
16
Maintaining 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

17
What 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

18
Registered NurseWorkforce in Nevada
19
Purpose 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

20
Licensed 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)

21
Estimated 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)

22
Age 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

23
Highest Level of Nursing Education of RNs in
Nevada 2005
24
Hispanic or Latino Heritage and Ability of RNs to
Speak Spanish 2005
25
Racial Background of RNs in Nevadaby Region
2005
26
Employment Setting of Principal Position of RNs
in Nevada 2005
27
Q.17. Satisfaction with Nursing as a Career
Nevada
28
Q.18. Satisfaction with Current Job Nevada
29
Q.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

30
Q.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

31
Q.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

32
Q.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

33
Q.23. Percent of RNs Having Knowledge of How to
Treat Casualties Involving
34
Q.23. Percent of RNs Having Knowledge of How to
Treat Casualties Involving
35
What 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

36
Dental Workforce in Nevada
37
Purpose 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

38
Nevada 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

39
Public Policy Implications and Discussion
40
Health 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

41
Health 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

42
Health 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

43
Health 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

44
Health 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

45
Additional 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
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