Workforce and Global Health

1
Workforce andGlobal Health

• H Edu 5100

2
Workforce

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

3
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
4
Turnover - Hospitals

• Overall 17.58
• Turnover by age
• 29 or younger 23.50
• 30-39 13.96
• 40-49 11.46
• 50 and older 6.86

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Turnover Hospitals by size and type

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

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LPNs

• Tenure 5.59 years
• Openings 3.82
• Age 38.62
• 18-24 6.77 individuals
• 50 4.23 individuals

7
RNs

• Tenure 9.00 years
• Openings 23.12
• Age 40.26
• 18-24 29.00 individuals
• 50 52.67 individuals

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Radiologic Technologists

• Tenure 7.31
• Openings 1.40
• Age 35.66
• 18-24 2.42
• 50 1.92

9
Physical Therapists

• Tenure 5.09 years
• Openings 0.33
• Age 35.44
• 18-24 0.23 individuals
• 50 0.62 individuals

10
Pharmacists

• Tenure 9.10 years
• Openings 0.86
• Age 39.11
• 18-24 0.40 individuals
• 50 2.20 individuals

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The Demand
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RNs

• 23 per Utah hospital 1,000 or so
• Nurse executives report similar numbers
• Utah Health Care Association reports a 24
  vacancy in LTC
• 75 of hospitals nationwide report difficulty
  hiring RNs (AHA TrendWatch, June 2001)

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Pharmacists

• 40 openings right now in hospitals.
• Consider retail pharmacy
• 21 vacancy rate nationwide (AHA Special
  Workforce Survey, June 2001)
• 50 of hospitals nationwide report difficulty
  hiring pharmacists (AHA TrendWatch, June 2001)

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The Supply
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Current Numbers (RNs)

• Total licensed RNs 17,566
• Total Working 13,257
• Difference 4,309

(Utah Medical Education Council, Feb 2002)
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Higher Education (RNs)

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

(2000-01 academic year)
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Higher Education Annual Utah Graduates

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

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Demand and Supply
19
Demand and Supply
20
Demand and Supply
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Concerns

• Aging workforce
• Aging population more services
• Aging faculty

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Concerns

• 2 of freshmen nationwide indicate nursing as a
  major
• Number of pharmacy graduates has decreased
• Enrollment and graduates do not keep pace with
  demand

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Counting the workforce

• Body count
• FTEs
• Paychecks

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Credentialing

• Why?
• Limitations
• Procedures
• Licensure
• Certification
• Registration

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Nursing

• History
• Levels
• PN
• RN
• ADN/NP
• Licensing

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Medicine

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

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Other health workers

• Dental
• Podiatry
• Chiropractors
• Optometrists

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Allied health personnel

• Pharmacists
• Clinical Lab Sciences
• Physical Therapy
• Radiologic Sciences
• Respiratory Therapy

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Current Issues

• Shortages
• California mandates

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Global Health
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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
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Statistics

• 5 Billion people
• Distribution
• U.S. 5 of population, 40 of budget
• China gt20 of population, lt1 of budget
• Does more spending better health?

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Economist categorization

• High income 10,000 per capita
• Medium income 1,000-7,500
• Low income lt 1,000

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International Trade

• Only a tiny fraction
• Products
• People and ideas