Workforce and Global 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 Hospitals55.3% Nursing and personal care facilities17.2% MD offices and clinics16.5% Dental offices and clinics6% Home health care5%

Turnover - Hospitals Overall = % Overall = % Turnover by age Turnover by age –29 or younger =23.50 % –30-39 =13.96 % –40-49 =11.46 % –50 and older = 6.86 %

Turnover – Hospitals by size and type beds = % beds = % beds =17.22 % beds =17.22 % beds =20.61 % beds =20.61 % Urban =18.93 % Urban =18.93 % Rural =16.99 % Rural =16.99 %

LPNs Tenure = 5.59 years Tenure = 5.59 years Openings = 3.82 Openings = 3.82 Age = Age = = 6.77 individuals = 6.77 individuals 50+ = 4.23 individuals 50+ = 4.23 individuals

RNs Tenure =9.00 years Tenure =9.00 years Openings =23.12 Openings =23.12 Age =40.26 Age = =29.00 individuals =29.00 individuals 50+ =52.67 individuals 50+ =52.67 individuals

Radiologic Technologists Tenure = 7.31 Tenure = 7.31 Openings =1.40 Openings =1.40 Age =35.66 Age = = = = =1.92

Physical Therapists Tenure =5.09 years Tenure =5.09 years Openings =0.33 Openings =0.33 Age =35.44 Age = =0.23 individuals =0.23 individuals 50+ =0.62 individuals 50+ =0.62 individuals

Pharmacists Tenure =9.10 years Tenure =9.10 years Openings =0.86 Openings =0.86 Age =39.11 Age = =0.40 individuals =0.40 individuals 50+ =2.20 individuals 50+ =2.20 individuals

The Demand…

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

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

The Supply…

Current Numbers (RNs) Total licensed RNs =17,566 Total licensed RNs =17,566 Total Working =13,257 Total Working =13,257 Difference = 4,309 Difference = 4,309 (Utah Medical Education Council, Feb 2002)

Higher Education (RNs) Undergrad applicants = 1,400 Undergrad applicants = 1,400 Undergrad admissions = 760 Undergrad admissions = 760 Undergrad graduates = 615 Undergrad graduates = 615 ( academic year)

Higher Education Annual Utah Graduates Respiratory Therapists = 50 Respiratory Therapists = 50 Clinical Laboratory = 35 Clinical Laboratory = 35 Radiologic Technologists = 85 Radiologic Technologists = 85 Physical Therapists = 36 Physical Therapists = 36 Pharmacists = 40 Pharmacists = 40

Demand and Supply

Concerns Aging workforce Aging workforce Aging population = more services Aging population = more services Aging faculty Aging faculty

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

Counting the workforce Body count FTEs Paychecks

Credentialing Why? Limitations Procedures  Licensure  Certification  Registration

Nursing History Levels  PN  RN  ADN/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 PrivatePluralisticNational 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 State employee and member of medical organizations Professional associations PowerfulVery strongStrongFairly strongWeak or nonexistent Ownership of facilities PrivatePrivate and public Mostly publicEntirely public Economic transfers DirectDirect and indirect Mostly indirectIndirectEntirely indirect PrototypesU.S., Western Europe U.S. in 20 th century Sweden, France, Canada Great BritainSoviet Union in 20 th century

Statistics 5 Billion people Distribution  U.S. = 5% of population, 40% of budget  China = >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