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The North Carolina Health Professions Data System

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Title: The North Carolina Health Professions Data System


1
The North Carolina Health Professions Data System
  • Katie Gaul, Erin Fraher,
  • Thomas C. Ricketts, Jessica Carpenter
  • University of North Carolina at Chapel Hill

2
Overview of Todays Presentation
  • The North Carolina Health Professions Data System
  • Mission
  • Background
  • Data Collection, Cleaning, Reporting
  • Organizational Issues
  • External Data Sources
  • WHY? Examples and Value of Work
  • Wrapping Up

3
Our Mission
  • To provide timely, useful data and analysis to
    support decision making for health professions
    policy in North Carolina and the United States
  • To support research into health workforce issues
    and problems
  • To train others in how to develop and maintain
    data systems in health workforce

4
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
5
North Carolina HPDS
  • A collaboration between the Cecil G. Sheps Center
    for Health Services Research at UNC-CH and the
    health professions licensing boards.
  • Data are provided voluntarily by the boardsthere
    is no legislation that requires this, there is no
    appropriation.
  • Core funding provided by
  • NC AHEC Program Office, data request fees,
    project cross-subsidies, and the UNC-CH Office of
    the Provost.

6
The System is Unique in the U.S.
  • 30 years of continuous, complete data
  • Comprehensive and voluntary collaboration with 12
    licensing bodies in North Carolina
  • Data remain property of licensing board,
    permission sought for each new use
  • System is independent of government or health
    care professionals

7
Categories of Health Professionals in Data System
  • Certified Nurse Midwives (1985)
  • Chiropractors
  • Dental Hygienists
  • Dentists
  • Licensed Practical Nurses
  • Nurse Practitioners
  • Occupational Therapists (2006)
  • Occupational Therapy Assistants (2006)
  • Optometrists
  • Pharmacists
  • Physical Therapists
  • Physical Therapist Assistants
  • Physician Assistants
  • Physicians (MDs and DOs)
  • Podiatrists
  • Psychological Associates
  • Psychologists
  • Registered Nurses
  • Respiratory Therapists (2004)

8
HPDS Data Collected from Boards
  • Base data from initial licensure/approval forms
  • Updated data from renewals of licensure and
    approvals to practice
  • Includes 100 of active professionals because
    licensure is required by law
  • We develop a Snapshot of files as of October of
    each year (Orange Book)

9
Data Items Collected
  • Demographic data
  • Data elements that usually dont change
  • Unique identifier
  • Name
  • Date and place of birth
  • Race/ethnicity
  • Gender
  • Basic professional degree (degree conferred, name
    and location of institution attended, practice
    qualifications)

10
Data Items Updated
  • Data elements that may change
  • Home address
  • Employment address
  • Type of position
  • Employment setting
  • Clinical practice area/specialty
  • Activity status (retired, active practice, not
    employed in profession)
  • Average hours per week/employment status
  • Highest degree
  • Foreign language ability (available from select
    boards)

11
Additional Data Items Collected for Physicians
and PAs
  • Primary, Secondary and Other practice location
  • ZIP Code location
  • Facility type
  • Hours in clinical care (by location)
  • Hours in primary care (by location)
  • Provide prenatal care?
  • Deliver babies?
  • Hospital Privileges (2007)
  • Licenses ever held in other states/countries
    (2007)

12
Licensure File Creation and Maintenance
(continued)
The entire process takes nearly a year from start
to finish
October
August
News Release
Review for changes
Trial Posts to web
Data come in
Edits, cleaning
Formatted initial analysis file
Data Book released
13
North Carolina Health Professions Data Book
  • Annual Health Professions Data Book, produced
    since 1979, details state and county level health
    professions data current issue October 2007
    data
  • Publications and research widely used by
    policymakers, educators, researchers, the media
    and health professionals as the official source
    of health professions statistics in NC
  • Supported by the North Carolina Area Health
    Education Centers Program and the University of
    North Carolina at Chapel Hill Office of the
    Provost

14
North Carolina Health Professions Data Book
  • Counts of active, licensed health professionals
  • Population by age group and race
  • Employment and income data
  • Vital statistics (births, deaths, pregnancies)
  • Infant mortality rates
  • Hospital and facility data

Aggregated by state, county and regions (AHEC,
DHHS, Perinatal)
15
HPDS Organizational Issues
16
Infrastructure Hardware/Software
  • Hardware
  • High end personal computers which are regularly
    upgraded (every 2-3 years)
  • Connected to Sheps Center servers allowing file
    sharing, storage of large files, automatic
    back-up
  • Label writer for mailing data requests
  • Cleaning and processing of licensure files is
    done on local desktop computer using SAS
  • Archive licensure files kept on UNC mainframe
  • Software
  • Microsoft Access - track data requests, do file
    audits, invoicing, data book pages
  • Microsoft Excel/Powerpoint - graphically present
    data
  • Macromedia Dreamweaver - web development
  • Adobe Acrobat - create PDF documents for website
  • Quark or Adobe InDesign - desktop publishing
  • Adobe Illustrator - format maps and graphics
  • MapInfo or ArcGIS - create maps and do spatial
    analysis
  • SAS or Stata - statistical analysis and
    programming

17
Dissemination
  • State-Level (examples)
  • State Legislators, Governors office, State
    Policy Makers
  • Health Professions Schools
  • All regional AHECs and their libraries
  • North Carolina State Library
  • North Carolina DHHS, Commerce
  • North Carolina Hospital Association and other
    employers
  • Professional Associations
  • Duke Endowment and Kate B. Reynolds Charitable
    Trust
  • North Carolina Institute of Medicine
  • National-Level
  • AAMC, other workforce centers, AHECs, and
    researchers
  • Federal Bureau of Health Professions, HRSA, NAO
  • Library of Congress
  • Email listserv 2,298 members, sign-up available
    on website

18
Basic Cost Estimates
19
Cost Estimate for Producing the Annual Data Book
Operating Costs
This is a general estimate of the costs to
produce the Data Book each year This does not
include funds necessary for infrastructure or
additional functions.
Fiscal Year 2007-2008
These estimates cover the production of the
annual HPDS Data Book and dont take into
account other projects that we design with the NC
AHEC Program and others.
20
Examples of Sources of Funding for Workforce
Research
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
Annual Contract Current Year, 116,849 NC AHEC
Program
  • State, Federal Foundation Funding
  • Development of Dental HPSA process (HRSA,
    450,000)
  • Evaluation of the National AHEC Program (BHPR,
    239,467)
  • Physician Workforce Study with NC IOM (Kate B.
    Reynolds 44,491)
  • Rural Pharmacist Workforce Study (ORHP, 78,808)
  • Supply of Psychiatrists in NC (NC AHEC, 30,000)
  • Need for Assistance (NFA) process (BPHC, 90,000)
  • SE Regional Center for Health Workforce Studies
    (HRSA, 1,000,000)

Multi Year Contract Total 2001-2007 262,476
(Duke Endowment and NC AHEC)
21
Data Request Revenue
  • July 1, 2006 August 30, 2007
  • 253 total data requests
  • 6,536.29 Encumbered
  • Average 5-10 contacts regarding requests per week
    (including all types and follow-ups on requests
    in process)
  • Revenue supports publication of the annual Data
    Book and other publications, helps cover
    programming and administrative time, and helps
    purchase miscellaneous supplies software
  • This is not typically a self-sustaining method to
    fund a data system

22
Data Sources
23
Examples of Secondary Data Sources
  • Supply and distribution of pharmacists in North
    Carolina HPDS data
  • Number, type and location of pharmacies in NC NC
    Board of Pharmacy
  • Population data Census, Claritas, State
    Demographer
  • Volume and payer type for prescriptions dispensed
    in NC IMS Health
  • Enrollments and graduations from NC pharmacy
    schools UNC-CH, Campbell
  • Informal interviews
  • Literature and internet searches
  • National workforce data BHPr, AMA, APA, AANP

24
HPDS benefits from other data sets at Sheps
  • Area Resource File (1994-present, intermittent
    files for previous years)
  • HPSA/MUA file
  • Claritas (1998-2000, 2003, 2005)
  • AMA Masterfile (1981, 1986, 1991, 1996, 2000,
    2001, 2004, 2005, 2006)
  • ADA Data (various)
  • NC Hospital Discharge Data (1989-2005, except
    1995)
  • NC Ambulatory Surgery Data (1997-2005)

25
Why? Examples and Value of Work
26
The Data System Can Help Answer Questions Like
  • How many dentists are there in North Carolina?
    Where are they practicing?
  • Are there too few psychiatrists in the state?
  • Are we retaining health professionals trained in
    North Carolina?
  • Will NCs supply of physicians keep pace with
    expected population growth?
  • Does the ethnic and racial distribution of health
    professionals match the population?
  • How well do the linguistic capabilities of
    practitioners match the language needs of North
    Carolinas citizens?

27
BUT it cant answer some types of questions for
lack of appropriate data
  • When do physicians actually retire?
  • Are fewer physicians delivering babies because of
    malpractice issues?
  • Are we facing a psychiatrist shortage because
    reimbursement rates are too low?
  • Where should we put the new (dentistry, pharmacy,
    satellite medical) school?
  • Goal to provide data-driven, timely and
    objective analyses to inform the policy debate.

28
The Basics Describing the Workforce
  • For example…
  • Supply of physicians is growing, but growth has
    slowed
  • Average age of physicians is increasing slightly
  • Gender is converging slowly for new physicians
  • Newly licensed physicians were more likely to be
    female, be minority or be younger
  • Of the physicians that left the file between
    2002-2003, 143 retired from practice and the
    average retirement age was 66
  • 27 of active physicians in 2003 completed
    medical school in NC 35 completed NC residencies

29
Makes analysis simple
  • Ongoing tracking stimulate attention and policy
    change
  • Having the trend data readily available makes it
    unnecessary to do complex studies
  • The data speak for themselves, and allows the
    stakeholders to feel some ownership in the data
  • Stakeholders can do their own analysis by
    asking us questions of the data which we can
    answer
  • Our data help people avoid doing large and
    complex (time-consuming) studies that cost a lot
    of money
  • In some cases, the Medical Board will include
    survey questions on their licensure and renewal
    forms, making it easier to collect data with
    broad interest

30
Informing Policy Makers
  • North Carolina General Assembly, 2003-2006
  • Planning for potential new schools of
  • Dentistry
  • Pharmacy
  • Optometry
  • Plans for expansion of medical, dental schools
  • Effects of malpractice insurance rate increases
  • Effects of changes in license rules

31
Trends in the Supply of Dentists in North
Carolina, 1996-2005
  • Policy Issue Dental access in rural NC
  • Key Findings
  • NC lags behind national supply
  • Between 1996-2005, 33 of counties experienced
    decline in dentists per 10K pop, 26 of 33 were
    rural counties
  • Aging dental workforce, especially in rural
    counties
  • 87 of dentists are white
  • Policy Response
  • Legislature appropriated 89.6 million for new
    dental school at ECU and 96 million For
    expansion at UNC-CH

February 2007
32
The Supply and Distribution of Psychiatrists in
North Carolina Pressing Issues in the Context of
Mental Health Reform
  • Policy Issue State decentralizing mental health
    serviceswill there be an adequate supply of
    psychiatrists?
  • Key Findings
  • Overall supply adequate, distribution is a
    problem
  • 44 counties qualify as mental health professional
    shortage areas
  • Of 19 counties that qualify as primary care
    HPSAs, 11 have shortage of psychiatrists
  • 43 counties have no child psychiatrists
  • Policy Response
  • Legislature gave 500,000 of recurring funding to
    AHEC to address maldistribution and supply. Pilot
    efforts focus on mid-levels, residents and
    tele-psychiatry, consultation models.

January 2006
33
(No Transcript)
34
NC AHEC, Sheps, NC IOM The Primary Care and
Specialty Physician Taskforce
  • HPDS data revealed in 2003 that rate of growth of
    physicians per10,000 population slowed
  • At same time, supply of primary care physicians
    did not keep pace with population in many rural
    counties
  • With funding from Kate B. Reynolds, NC IOM
    convened taskforce to examine issue
  • Nurse practitioners, physician assistants and
    certified nurse midwives included

35
The Primary Care and Specialty Physician
Taskforce Supply Projections
  • Key Findings
  • Despite rapid growth of NPs and PAs, NC provider
    supply will not keep pace with population
  • NC IOM made 32 recommendations to the legislature
    to address supply, diversity and maldistribution
  • Final report released June 2007 available at
    http//www.nciom.org

105
.75 FTE, faster growth
100
95
Ratio Relative to 2004 Level
90
85
.5 FTE, slower growth
80
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
Year
36
(No Transcript)
37
Wrapping Up
38
Giving Back to the Boards
  • Health Professions Licensing Boards
  • Consult on new or modified questions on licensing
    forms
  • Language ability (Pharmacy, Nursing, Medicine)
  • Race (Pharmacy)
  • Activity status (Physical Therapy)
  • Help evaluate online registration (Medical Board,
    Nursing)

39
Lessons Learned
  • Data driven workforce analyses necessary to
  • Monitor longitudinal trends in supply and
    distributionestablish benchmarks. Are we worse
    or better off?
  • Identify emerging workforce issues
  • Challenge anecdotal evidence
  • Be perceived as objective in politically charged
    policy debates
  • Justify funding requests
  • Tackle discrete policy-relevant and manageable
    size projects
  • Disseminate results in short policy briefs with
    lots of pictures (maps are good…)

40
Health Workforce Planning The Future
  • Workforce issues are not going away
  • Federal workforce research funds have been cut
    and there are limited national data
  • Responsibility falls on individuals statesmost
    policy levers are at state-level

41
Moving Forward
  • We (HPDS) are starting to shift from classic
    workforce studies (assign physician to place,
    counts by county, look at distribution, etc.) to
    more in-depth analyses
  • Involves merging administrative and other
    databases onto our licensure files to capture
    more detailed information
  • Dr. John Doe is not just a surgeon at ABC
    Hospital Dr. Doe does this many of these
    particular procedures on these types of patients
    per year, and has shifted from doing general
    surgery to more specialized surgical procedures

42
Recommendations
  • Start small and make a big impact
  • Expand later
  • Get a good team together - people with different
    skill sets who work well together and can learn
    from each other
  • What youre looking to do will inform state
    policy look for some state money to fund this
    (dont depend solely on federal funding sources)
  • Stay objective and maintain credibility

43
Contact Us
Erin Fraher, Director erin_fraher_at_unc.edu (919)
966-5012
Katie Gaul k_gaul_at_unc.edu (919) 966-6529
Tom Ricketts tom_ricketts_at_unc.edu (919) 966-5541
Jessica Carpenter jmcarpen_at_unc.edu (919) 843-3402
Cecil G. Sheps Center for Health Services
Research University of North Carolina at Chapel
Hill 725 Martin Luther King Jr. Blvd, CB
7590 Chapel Hill, NC 27599 HPDS Main Line (919)
966-7112, nchp_at_unc.edu
44
HPDS Website http//www.shepscenter.unc.edu/hp
  • County- and region-level data
  • Historical health professions trends (1979-2006)
  • Practitioner per 10,000 population ratios and
    maps
  • Data definitions
  • HPDS publications, press releases
  • Powerpoint presentations
  • Data request instructions
  • General information about the HPDS frequently
    asked questions
  • Sign-up for HPDS listserv
  • Links to NC licensing boards, other national and
    state health workforce sites, other useful
    statistics sources

45
Extra Slides
46
Overview
  • The North Carolina Health Professions Data System
  • Background
  • Organizational Issues
  • Data Sources
  • Special Reports and Projects
  • Allied Health
  • WHY? Examples and Value of Work
  • Wrapping Up
  • Contact Information

47
The Cecil G. Sheps Center for Health Services
Research
  • Founded in 1968 is one of the oldest and largest
    health services research centers in the nation
  • Is an organizational unit of the University of
    North Carolina at Chapel Hill in the Health
    Affairs Division
  • 14 million annual budget (2006)
  • Employs or houses 170 staff including senior
    faculty, research fellows, analytic staff,
    fellows and graduate students
  • Over 130 research fellows based in other academic
    departments, state and federal government,
    private industry and other countries are
    affiliated with the Sheps Center

48
Data Request Process
  • Receive requests by
  • Email
  • Fax
  • Phone
  • Informational Requests
  • Non-Sheps Data refer to appropriate source (if
    possible)
  • HPDS Data request procedures
  • HPDS General Information
  • Requests tracked in contact database (MS Access)
  • Requestors name contact information
  • Detailed description of request
  • Output type
  • Due date date sent

49
Data Request Process
  • Two types of data requests
  • Off the shelf data and publications
  • Aggregate statistics found on HPDS website or
    Data Book (e.g. How many RNs are active in Durham
    County?)
  • Requests for Publications (Data Book, fact
    sheets)
  • Requests requiring data processing
  • Aggregate statistics not found in HPDS
    publications (e.g. How many family practice
    physicians in the state provide obstetric
    deliveries?)
  • Individual level data
  • Mailing lists (e.g. Regional MS Society sending
    educational fliers to local physicians Companies
    advertising CE programs to psychologists)
  • Analysis files for research

Permission sought from board to release
individual level data
50
Data Requests Requiring Processing
  • Requests tracked in contact database (MS Access)
  • Requestors name contact information
  • Detailed description of request
  • Output type
  • Due date date sent
  • Fees
  • Health Professions Data Book
  • 20.00 per book, plus postage
  • Mailing lists (name, address, county, specialty)
  • 4.50 per 100 names for electronic files
  • 100 minimum, non-profit organizations 200
    minimum, for-profit organizations
  • 600 maximum
  • Analysis files (including the above plus
    additional demographic and practice
    characteristics)
  • 7.00 per 100 names for electronic files
  • 200 minimum, non-profit organizations 300
    minimum, for-profit organizations
  • 700 maximum, non-profit organizations 800
    maximum, for-profit organizations
  • Requests requiring programming
  • 50.00 per hour for substantial requests (else
    free)

Discounts given for AHECs, students, UNC System,
North Carolina State Agencies, and at the
Directors discretion
51
Organizational Issues Personnel
Center Director
Deputy Director Research
Deputy Director Operations
Deputy Director Policy Analysis Tom Ricketts, PhD
Director Program on Primary Care Health
Professions
Associate Director Health Policy Information
Director NC Rural Health Policy Analysis
Associate Director Policy Analysis
Director Health Professions Erin Fraher, MPP
50
Associate Director Data Mgmt Information
Services
Programmer
Research Associate
100
Data Coordinator
Programmer
100
Research Associate
Research Assoc
Programmer
Programmer
50
10
Graduate RA 10hrs
Graduate RA 20 hrs
52
HPDS Benefits from Sheps Center Infrastructure
Computer and Data Management Support
Executive
Other Research Areas
Administrative Support
Health Professions Data System
Business and Financial Support
Programming
Media and Communications
Information and Library Services
53
Infrastructure Cartography and Geographic
Analysis Capabilities
  • Maps with HPDS data are prepared using
    cartographic software that provides a Geographic
    Information System (GIS) interface such as ESRIs
    Arc Suite (ArcView, ArcInfo, ArcGIS, ArcIMS),
    and MapInfo
  • MapInfo / ArcView - Data System has benefited
    from availability of cartographic software and
    expertise through the NC Rural Health Policy
    Research and Analysis Program.
  • There are three licenses for MapInfo in the
    Center.
  • The Center may shift over to ArcView because UNC
    has an unlimited number of licenses.
  • Rural program buys Claritas products for ZIP to
    county coding and address matching.
  • Other GIS products are used as needed

54
Infrastructure Library Services
  • Sheps employs two full-time librarians who
    oversee the Centers library holdings
  • Librarians conduct customized bibliographic
    research from electronic sources for researchers
  • Librarians manage a Rural Policy collection,
    which includes over 11,000 items related to rural
    health, primary care, health policy dated back to
    1978
  • Rural policy collection regularly deposits and
    cross-references items from the Federal Office of
    Rural Health Policy (OFRHP), General Accounting
    Office (GAO), the Office of Management and Budget
    (OMB), the Congressional Budgeting Office (CBO),
    Medicare Advisory Payment Commission (MedPAC) and
    the Bureau of Health Professions (BHPr)

55
Infrastructure Dissemination
  • Center normally employs two full-time Information
    and Communication Specialists, who assist in the
    development written and published material these
    positions are currently vacant
  • Provide copy editing, prepare fact sheets, and
    respond to short term queries for information
  • Center employs two full-time web masters with
    distributed responsibilities
  • Press releases and Press events are managed in
    collaboration with the UNC Office of Public
    Affairs

56
Electronic Dissemination
  • Email listserv
  • Updates to website
  • New publications and news items
  • Sent to key policy makers, educators,
    researchers, employers, etc.
  • Sign-up available on the HPDS website
  • 2,298 people on the list

57
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
58
The Basics Benchmarking
  • Benchmark to US practitioner-to-population ratio
  • Benchmark to neighboring states
  • Problems
  • What is an active practitioner?
  • Counting bodies vs. calculating FTEs
  • Dealing with missing data?
  • Allocating individuals with more than one
    practice location and out-of-state locations
  • Allocating individuals based on in primary care
  • Difficulty in quantifying a shortage, how many
    practitioners is too few?

59
Health Professions Data System Recent Products
  • Special reports
  • Trends in Licensed Health Professions in North
    Carolina, 1979-2005
  • Fact Sheets
  • Physician Medical and Residency Training Fact
    Sheet, 2005, 2003, 2001,1999,1997,1995
  • Allied Health Job Vacancy Tracking Reports (Apr.
    2007, Aug. 2006, Apr. 2005)
  • Trends in the Supply of Dentists in NC, 1996-2005
  • The Supply and Distribution of Psychiatrists in
    North Carolina Pressing Issues in the Context of
    Mental Health Reform
  • Trends in the Supply of NPs and PAs in NC,
    1990-2001

60
Trends in Physicians Delivering Babies
61
Osteopaths, relatively few, but growing fast in
numbers
400
350
300
250
Number of DOs
200
150
Growth rate of gt10 per year
100
50
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
62
Evaluation
63
Medical Student Tracking (Class of 1996)
North Carolina Medical Students-Retention in
Primary Care 1996 Graduates
Primary Care Family Medicine, General
Pediatric Medicine, General Internal Medicine,
Internal Medicine/Pediatrics, and
obstetrics/gynecology.
Sources
64
Medical Student Tracking (Class of 2002)
North Carolina Medical Students-Initial Choice of
Primary Care 2002 Graduates
Primary Care Family Medicine, General
Pediatric Medicine, General Internal Medicine,
Internal Medicine/Pediatrics, and
obstetrics/gynecology.
Sources
65
Informing Policy Makers NC AHEC Special
Requests
  • Provide research support to Central NC AHEC
    office
  • Rural Curve
  • Retention of physicians who do NC/AHEC residency
  • Other miscellaneous requests

66
Allied Health Studies
67
HPDS 3 Main Product Lines
Maintenance of Licensure Data Files for HPDS
Special Projects Service to the State and the
Institution
Allied Health Workforce Studies
This function is the backbone of our work. It
takes substantial time and staff effort to
collect, clean, edit, and disseminate licensure
data. Sustaining maintaining this
infrastructure is challenging.
The HPDS often undertakes special research
projects at the request of the NC AHEC, UNC Board
of Governors (respond to legislation, make
presentations), licensure boards etc. This
service has increased the visibility of the Sheps
Center to important local sponsors and
policymakers.
Funded by the Duke Endowment and the NC AHEC,
research has focused on quantifying the supply
of, and demand for, allied health workers.
Findings highlighting the growth of allied health
employment have gained the attention of policy
makers. Staff in the Governors office, the
legislature, and other state agencies are working
to develop innovative ways to transition
unemployed individuals into allied health jobs.
68
The State of Allied Health in NC
  • Policy Issue Making link between allied health
    workforce vacancies and economic development in
    rural NC
  • Key Findings
  • Between 1999-2005, overall employment in NC grew
    by 0.2 compared to 20.2 growth in health care
    jobs and 45.8 increase in allied health
    employment
  • Allied health comprises 37 of all health care
    jobs
  • 8 of top 10 fastest growing professions (across
    all employment sectors in are in allied health)
  • Policy Response Pending
  • We have requested funding for continued
    monitoring of allied health workforce

May 2005
69
Manufacturing and Health Care Social Assistance
Employment, NC, 1995-2005
900
822, 995
800
Manufacturing
700
568,835
600
Employment (thousands)
500
491,637
400
Health Care Social Assistance
300
332,446
200
100
0
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Year
Source North Carolina Employment Security
Commission, 2006.
70
Healthcare and Allied Health Jobs Grew, Overall
Employment Remained Stagnant
Total State, Healthcare and Allied Health
Employment, North Carolina, 1999-2005
Source Bureau of Labor Statistics. Occupational
Employment Statistics. State Cross-Industry
Estimates 1999-2005. URL http//www.bls.gov/oes
/. Accessed 06/28/2006.
71
North Carolinas Fastest Growing
Occupations Percent Change in Employment,
2002-2012
http//eslmi23.esc.state.nc.us/projections/Employm
entOutlook.asp?versionaopengpAreaType01Area00
0037PeriodID06
72
Health Care Jobs in North Carolina, 2005
Other, 3
Physicians, 5
LPNs, 5
Allied Health Professions, 37
RNs, 24
Total Health Care Jobs 302,270
Nurse aides, orderlies and attendants, 26
Note "Other healthcare occupations" includes
chiropractors, dentists, optometrists, and
pharmacists. Source U.S. Bureau of Labor
Statistics, Occupational Employment Statistics
(2005). URL http//www.bls.gov/oes/.
73
Job Vacancy Tracking Reports
  • Purpose Estimate workforce demand for selected
    allied health professions
  • Method Monitor weekly job listings in newspaper
    and online sources
  • Data Latest data collected for twelve
    professions during 10 week period (September
    24-November 26, 2006)
  • Results
  • Number of vacancies
  • Distribution of vacancies by region and
    profession
  • Types of employers advertising vacancies

April 2007 August 2006 April 2005
74
Medical Assistants Employed in North Carolina,
2002-2006
Medical assistants are growing at nearly double
the projected growth rate
Source North Carolina Health Professions Data
System with data from the Employment Security
Commission
75
Licensure File Creation and Maintenance
  • Files are received annually from Boards,
    effective Oct. 31
  • Applications analyst programmers clean and edit
    files
  • Compare new files to previous year to look for
    changes in variables
  • Code individuals to counties based on ZIP code
    data
  • There are checks in place to flag inconsistencies
    which we then investigate, but otherwise we do
    not verify the accuracy of each record
  • Generate tables of summary statistics for review
    by Data Book Coordinator

76
Licensure File Creation and Maintenance
(continued)
  • File audit
  • Aggregated totals by variable are compared to
    previous years by state and county
  • Programmers scrutinize files where strange
    patterns are detected
  • Final review by HPDS staff and approval for
    release
  • Feedback to Boards
  • Tables of aggregate statistics by geographic
    region are returned to boards for their reference
  • HPDS sends feedback to boards on potential data
    collection issues, trends in the data

77
Licensure File Creation and Maintenance
October
Files received from Boards, effective Oct. 31
Compare variables received to previous years
variables
Applications analyst programmers clean and edit
files
Code individuals to county based on ZIP code
Release Data Book, Post data to web
The entire process takes nearly a year from start
to finish
August
Feedback to Boards
Generate tables of summary stats for review
File Audit compare, investigate
Final review, approval for release
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