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PubMed1996

Studying the impact of women on osteopathic physician workforce predictions.

Women have been entering the physician workforce in ever-increasing numbers since the 1970s, and women are expected to reach numeric parity with men early in the next century. In an effort to predict changes in the physician workforce, analysts have relied primarily on data collected in the allopathic medical profession. Documented differences in practice characteristics between osteopathic and allopathic physicians make current workforce projections--based heavily on assumptions rooted in the allopathic medical profession--nonrepresentative of the osteopathic medical profession. The authors attempt to identify the impact of increasing numbers of women physicians on the osteopathic medical profession. They trace the historical presence of women in medicine and explore speculations concerning the continued growth in the numbers and percentage of women in medicine. The authors analyze data from the 1992 AOA census in search of identifiable trends in practice location and specialty choice based on gender, marital status, and dual-osteopathic physician couples. Finally, they discuss the need for complete and accurate data collection for the profession as data-driven workforce policy decisions ultimately affect the entire profession.

Female↗

PubMed2000

Final report of the FOPE II Pediatric Workforce Workgroup.

From the inception of the Future of Pediatric Education II (FOPE II) Project, it was acknowledged that any discussion of pediatric education would need to encompass a review of the pediatric workforce. This report looks at the current trends in pediatric workforce and draws some conclusions regarding future growth and composition. In addition to looking at demographic trends, ranging from geography to gender, the report explores influences including managed care, telemedicine, and others. Models for determining workforce needs are described and scenarios and projections are discussed. Pediatrics 2000;106(suppl):1245-1255; pediatric workforce.

Adult↗

PubMed2001

Managing the consequences of hospital cutbacks: the role of workforce reduction practices.

In recent years, hospitals in Canada as elsewhere have witnessed unprecedented downsizing of their workforces. It is generally assumed that planned workforce reductions can have deleterious consequences on an organization's human resources. Scholars and practitioners alike have identified a number of humane or progressive approaches that are widely considered to be effective for organizations undergoing downsizing. This study examines the impact that workforce reduction approaches have on perceptions of organizational performance in a large sample of Canadian hospitals undergoing workforce reductions.

Benchmarking↗

PubMedDate not supplied

Benchmarking the future generalist workforce.

CONTEXT: Previous workforce analyses by the Council on Graduate Medical Education (COGME) have concluded that the United States has too few, or just enough, generalists. However, recent trends suggest that more physicians are entering primary care, raising the possibility of a future surplus. OBJECTIVE: To project the future supply of generalists relative to future requirements. DESIGN: We developed a model that projects the supply of generalists into the future on the basis of the annual number of physicians entering and leaving the workforce. We calculated the number of clinically active generalists from the physician master-files of the American Medical Association and American Osteopathic Association. The number of graduating trainees entering the generalist workforce was calculated from the 1999 to 2000 AMA Annual Survey of GME. The number leaving was calculated by using age- and sex-specific rates or physician death and retirement provided by the Bureau of Health Professions. MEASUREMENTS: Projected per capita number of clinically active generalists to the year 2025, relative to physician requirements suggested by COGME and several regional benchmarks of physician supply. RESULTS: The supply of generalists is projected to grow from its current level of 69 per 100,000 to nearly 88 per 100,000 by the year 2025. Adjusting for the changing age-sex structure of the physician workforce decreases the "effective" supply to 85 generalists per 100,000. By the year 2025, the effective supply of generalists will exceed COGME's upper estimate of generalist requirements (80 per 100,000), resulting in an excess of about 18,000 full-time equivalent generalists. The future supply of generalists will also exceed most current regional benchmarks of generalist supply. CONCLUSION: At current levels of training, the supply of generalists will grow substantially and soon exceed several benchmarks for generalist requirements.

Benchmarking↗

PubMed2004

Challenges confronting the health workforce in sub-Saharan Africa.

Sub-Saharan Africa and the international health community face a daunting challenge to deal with an extraordinary disease burden and improve the health status of Africans. Despite decades of effort to provide effective, equitable and affordable health care services, the health indices of Africans have stagnated and in some instances have deteriorated. Africa is the only continent that has not fully benefited from recent advances in biomedical sciences that brought health tools and technologies to tackle most of the disease burden. The emergence of the HIV/AIDS epidemic has confounded the health scene and posed further challenges. Several factors are responsible for this state of affairs: macro factors, that represent the broader socio-cultural environment that impact on health, and micro factors, which are largely health sector specific. There is increasing recognition that the major limiting factor to improved health outcomes is not lack of financial resources or health technologies but the lack of implementation capacity which depends on the presence of a functional health system. The drivers and architects of this are health workers, 'the most important of the health system's input'. The Commission on Macroeconomics and Health advocates a greatly increased investment in health rising in low income countries to a per capita expenditure of US $34 per year and states that the problem in implementing this recommendation is not difficulty in raising funds but the capacity of the health sector itself to absorb the increased flow. Yet, until fairly recently sufficient attention has not been directed to the role of the health workforce. The failure to develop and deploy an appropriate and motivated health workforce, and the environment necessary for the workforce to perform optimally is clearly a critical determinant of the health status of Africans. This paper summarizes key issues facing the workforce and outlines a framework to develop strategies to address them.

Africa South of the Sahara↗

PubMed2005

A conceptual model for recruitment and retention: allied health workforce enhancement in Western Victoria, Australia.

Attracting and retaining allied health professionals in rural areas is a recognised problem in both Australia and overseas. Predicted increases in health needs will require strategic actions to enhance the rural workforce and its ability to deliver the required services. A range of factors in different domains has been associated with recruitment and retention in the allied health workforce. For example, factors can be related to the nature of the work, the personal needs, or the way an organisation is led. Some factors cannot be changed (eg geographical location of extended family) whereas others can be influenced (eg education, support, management styles). Recruitment and retention of allied health professionals is a challenging problem that deserves attention in all domains and preparedness to actively change established work practices, both individually as well as collectively, in order to cater for current and predicted health needs. Changes to enhance workforce outcomes can be implemented and evaluated using a cyclic model. The Allied Health Workforce Enhancement Project of the Greater Green Triangle University Department of Rural Health (GGT UDRH) is working towards increasing the number of allied health professionals in the south west of Victoria. Based on themes identified in the literature, an interactive model is being developed that addresses recruitment and retention factors in three domains: (1) personal or individual; (2) organisation; and (3) community.

Adult↗

PubMed2005

[Nursing human resources from the perspective of workforce: an analysis of the scientific production].

The focus of this research is on human resources in nursing, particularly from the perspective of workforce. The objectives are to identify the national scientific production on human resources in nursing, analyze particularly those publications about workforce in nursing, and give a historical perspective on the composition of nursing workforce and the distribution of nursing workers throughout the country. In this bibliographic research LILACS, PeriEnf, DEDALUS, BDENF, PAHO, MS, ADSAUDE, ENSP, FSP, TEXTOC and SIDORH's databases were consulted, as well as CEPEn's catalogues, from 1958 to 2001. 469 publications were identified: 345 (73,6%) utilized human resources in nursing as a descriptor, while 79 (16,8%) and 45 (9,6%) utilized, respectively, the keywords nursing workforce (FTE) and nursing work market. There is a higher concentration of scientific production in the second half of the 80's and throughout the 90's.

Nursing↗

PubMedDate not supplied

Are schools of public health needed to address public health workforce development in Canada for the 21st century?

In addition to establishing Canadian federal institutions for public health to work in cooperation with provincial and local health authorities, the infrastructure of public health for the future depends on a multi-disciplinary and well-prepared workforce. Traditionally, Canada trained its public health workforce in schools of public health (or hygiene), but in recent decades this has been carried out in departments and centres primarily within medical faculties. Recent public health crises in Canada have led to some new federal institutions and reorganization of public health activities as well as other reforms. This commentary proposes re-examination of the context of public health workforce training and especially for schools of public health as independent faculties within universities as in the United States or, as developed more recently in Europe, semi-independent schools within medical faculties. The multi-disciplinary nature of public health professionals and the complex challenges of the "New Public Health" call for a new debate on this vital issue of public health workforce development. Public health needs a new image and higher profile of training, research and service to meet provincial and national needs, based on international standards of accreditation and recognition.

Accreditation↗

PubMed1995

Forecasting physician workforce requirements in Minnesota.

The existing oversupply, specialty imbalance, and geographic maldistribution of clinicians are inconsistent with the goals of health system reform in Minnesota. Health professional workforce projections can help the private and public sectors make informed decisions to assure that the future supply of health professionals reasonably approximates requirements. Appropriate methodologies for projecting national health professional requirements, based on existing HMO staffing patterns, should be applied to Minnesota. In the absence of workforce projections, a variety of assumptions about changes in Minnesota's health care system that will affect workforce supply and requirements can, nonetheless, be made. Limitations on the state's ability to influence the health professional workforce within its borders are noted.

Cost-Benefit Analysis↗

PubMed1994

Workforce predictions: a situational analysis and critique of the World Health Organisation model.

The FDI/WHO JWG6 Computer Program is a needs-based, demand-weighted method of workforce prediction. Using this program and recent Victorian epidemiological data the objectives of the investigation were: to calculate the current state of community need for dental services and personnel in the State of Victoria; to forecast community service and personnel needs for the years 2000 and 2020; and to report qualitatively on the program's value as a workforce planning tool. High, low and moderate estimates of workforce requirements for the year 1988 were obtained by modifying certain variables related to needs/demands. The moderate estimate was used to calculate the number of operators needed within the population, and this demonstrated a required operator to population ratio of 1:2,019. Results for the year 2000 predicted the operator to population ratio required in Victoria will be 1:1,988 and for the year 2020, 1:2,165. Conclusions concerning the WHO program are firstly that it suggests a present under-supply of oral health care providers which is likely to increase by the year 2020 and secondly that it is a useful tool for workforce planning and monitoring.

Adolescent↗

PubMed1995

The changing workforce: the role of health psychology.

Because the federal government is the largest payer of all health costs, unbridled increases in the health workforce have profound fiscal implications. Recent efforts to control health spending through modifications of health delivery systems are related to the consequences of the unlimited production of health professionals. However, the federal government has established processes to review physician workforce changes, and these mechanisms have become important in accessing federal training monies. Psychologists have no concerted workforce policy and receive little federal training money. Moreover, other health professionals have attained statutory authority to perform and provide the same services as psychologists. This diffusion of professional functions impedes the ability to assess the status of the workforce and the development of psychology as a health profession.

Delivery of Health Care↗

PubMed1997

The changing vascular surgery workforce.

An adequate workforce is requisite for efficient and quality surgical care of patients having vascular disease. Data from 1985 and 1992 United States workforce studies provide the basis for certain projections. Vascular surgeons performed 41% of vascular operations in 1985 and 51% in 1992. The basis for this change seems related to the fact that younger general surgeons are less likely to practice vascular surgery than retiring senior general surgeons, whom they are replacing, and vascular surgeons have assumed the care of patients usually treated by the latter group of surgeons. Our aging society compounds this change. Patients older than 65 years will exhibit a 73% increase from 2010 to 2030, with a subsequent greater need for more vascular operations, which are predicted to be 1,020,067 in 2020, compared with 583,000 in 1992. A larger workforce will be required to meet this need. Although innovative technology and changes in health care delivery may cause unpredictable changes in these anticipated workforce needs, the potential exists that there will be insufficient numbers of surgeons available to provide adequate surgical care early in the next century, unless changes occur in the training and practice of general and vascular surgeons.

Aged↗

PubMed2002

Prevalence of alcohol and drug use in a highly educated workforce.

This study examined alcohol and licit and illicit drug use in a highly educated workforce. A comprehensive health survey of a 10% random sample of a workforce (n = 8,567) yielded a 60% response rate (n = 504) after accounting for 15 undeliverable surveys. Many respondents reported past-year use of alcohol (87%). Thirteen percent of respondents consumed three or more drinks daily; 15% were binge drinkers. Twelve percent of the workforce was assessed as having a high likelihood of lifetime alcohol dependence; 5% of respondents met criteria for current problem drinking. Overall, 42% reported using mood-altering prescription drugs (analgesics, antidepressants, sedatives, or tranquilizers). Eleven percent reported using illicit drugs (cocaine, hallucinogens, heroin, or marijuana) in the past year. Significant relationships were found between gender, age, ethnicity, and occupation with some measures of alcohol consumption and use of mood-altering drugs. These results indicate prevention and early intervention programs need to address use of mood-altering substances (including alcohol) in highly educated workforces.

Adult↗

PubMed2006

Prevalence and distribution of illicit drug use in the workforce and in the workplace: findings and implications from a U.S. national survey.

This U.S. national study explored the overall prevalence, frequency, and distribution of illicit drug use in the workforce and in the workplace during the preceding 12 months. Illicit drug use in the workforce involved an estimated 14.1% of employed adults (17.7 million workers). Illicit drug use in the workplace involved an estimated 3.1% of employed adults (3.9 million workers). Illicit drug use in the workforce and in the workplace is not distributed uniformly in the employed population. At-risk, though circumscribed, segments of the U.S. workforce were identified with prevalence rates up to 55.8% for any use of illicit drugs and up to 28.0% for illicit drug use in the workplace. The implications of these data for future theoretical research and for management policy and practice are discussed.

Adolescent↗

PubMed2006

A dental workforce review for a Midlands Strategic Health Authority.

OBJECTIVE: To explore opportunities for workforce development in NHS general dental services (GDS) in Shropshire and Staffordshire. METHOD: Secondary data sources were supplemented with a primary survey of GDS practices to build up a profile of the existing GDS workforce and its current capacity. Attitudes and perceptions on current workforce issues and potential solutions were gathered using a second survey and explored further through other qualitative techniques including interviews and a focus group discussion. RESULTS: The results confirm that there is a shortage of dentists in the area, fuelled by multiple factors including the move from NHS to private work, the decision to retire early and a growing disillusionment with NHS policies and remuneration. Modelling of alternate approaches to future dental clinical needs highlighted the opportunity for meeting the consequent workforce demands through increased involvement of hygienists and therapists. CONCLUSIONS: This study has provided local evidence to inform dental service development in Shropshire and Staffordshire. It has provided a starting point for exploring new ways of working and will contribute towards a more effective implementation of new and evolving service strategies.

Attitude of Health Personnel↗

PubMed2003

Improvement, trust, and the healthcare workforce.

Although major defects in the performance of healthcare systems are well documented, progress toward remedy remains slow. Accelerating improvement will require large shifts in attitudes toward and strategies for developing the healthcare workforce. At present, prevailing strategies rely largely on outmoded theories of control and standardisation of work. More modern, and much more effective, theories of production seek to harness the imagination and participation of the workforce in reinventing the system. This requires a workforce capable of setting bold aims, measuring progress, finding alternative designs for the work itself, and testing changes rapidly and informatively. It also requires a high degree of trust in many forms, a bias toward teamwork, and a predilection toward shouldering the burden of improvement, rather than blaming external factors. A new healthcare workforce strategy, founded on these principles, will yield much faster improvement than at present.

Delivery of Health Care↗

PubMed2003

Uses of population census data for monitoring geographical imbalance in the health workforce: snapshots from three developing countries.

BACKGROUND: Imbalance in the distribution of human resources for health (HRH), eventually leading to inequities in health services delivery and population health outcomes, is an issue of social and political concern in many countries. However, the empirical evidence to support decision-making is often fragmented, and many standard data sources that can potentially produce statistics relevant to the issue remain underused, especially in developing countries. This study investigated the uses of demographic census data for monitoring geographical imbalance in the health workforce for three developing countries, as a basis for formulation of evidence-based health policy options. METHODS: Population-based indicators of geographical variations among HRH were extracted from census microdata samples for Kenya, Mexico and Viet Nam. Health workforce statistics were matched against international standards of occupational classification to control for cross-national comparability. Summary measures of inequality were calculated to monitor the distribution of health workers across spatial units and by occupational group. RESULTS: Strong inequalities were found in the geographical distribution of the health workforce in all three countries, with the highest densities of HRH tending to be found in the capital areas. Cross-national differences were found in the magnitude of distributional inequality according to occupational group, with health professionals most susceptible to inequitable distribution in Kenya and Viet Nam but less so in Mexico compared to their associate professional counterparts. Some discrepancies were suggested between mappings of occupational information from the raw data with the international system, especially for nursing and midwifery specializations. CONCLUSIONS: The problem of geographical imbalance among HRH across countries in the developing world holds important implications at the local, national and international levels, in terms of constraints for the effective deployment, management and retention of HRH, and ultimately for the equitable delivery of health services. A number of advantages were revealed of using census data in health research, notably the potential for producing detailed statistics on health workforce characteristics at the sub-national level. However, lack of consistency in the compilation and processing of occupational information over time and across countries continues to hamper comparative analyses for HRH policy monitoring and evaluation.

Journal Article↗

PubMed2006

Considerations for increasing the competences and capacities of the public health workforce: assessing the training needs of public health workers in Texas.

BACKGROUND: Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them. METHODS: A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services. RESULTS AND CONCLUSION: Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public.

Journal Article↗