Health Workforce Data Collection: Findings from a Survey of States

Transcription

1 Health Workforce Data Collection: Findings from a Survey of States Jean Moore, DrPH David Armstrong, PhD Health Workforce Technical Assistance Center School of Public Health University at Albany, SUNY October 19, 2015 healthworkforceta.org

2 Survey of State Health Workforce Data Collection Activities Growing interest in developing state health workforce data collection and monitoring systems o driven in part by health reform initiatives that are reshaping health care service delivery and health workforce demand Need to better understand supply and distribution of current health workforce Need to assess the adequacy of primary care capacity Need to understand the relationship between access to care and health workforce availability HWTAC launched an on-line survey of states about their health workforce data collection activities on o Supply o Demand o Educational pipeline healthworkforceta.org 2

3 What workforce data are needed? Workforce supply Educational Pipeline Demand for workers 3

4 To Date, 40 Organizations in 32 States Report Collecting Health Workforce Data WA OR CA NV ID UT AZ MT WY CO NM ND SD NE KS OK MN IA MO AR WI IL MS MI OH IN WV KY TN SC AL GA NY PA NJ MD DE DC VA NC VT NH CT MA RI ME TX LA HI AK FL healthworkforceta.org 4

5 Who Collects Workforce Data? State agencies State universities Nursing centers Area Health Education Centers healthworkforceta.org 5

6 Health Workforce Supply Data Collection 40 organizations in 32 states report collecting supply data Professions vary by state: o Physicians (27 states) o Nurse practitioners (23 states) o Dentists (22 states) o Registered nurses (22 states) healthworkforceta.org 6

7 Supply Data Collection Strategies 26 states collect supply data routinely in conjunction with licensing/relicensing 8 states report using recurring surveys that are not associated with licensing process Some states report different data collection strategies for different professions A few states report other strategies such as telephone or in-person interviews healthworkforceta.org 7

8 Health Workforce Supply Data Collection Mandatory, Voluntary or Both? healthworkforceta.org 8

9 Mandatory Data Collection Most Likely for Physicians and Nursing Professionals Registered nurses (9 states) Nurse practitioners (9 states) Physicians (8 states) Nurse midwives or midwives(8 states) Licensed practical nurses (8 states) Certified registered nurse anesthetists (8 states) healthworkforceta.org 9

10 What Supply Data Variables are Collected? Most states report collecting health professional supply data on: o Demographics characteristics (30 states) o practice characteristics (30 states) and o educational backgrounds (26 states) 25 states collect health professional supply data in all three of these categories healthworkforceta.org 10

11 Emerging titles o o o o Who s Missing? Care coordinators Care managers Patient navigators Community health workers Home health aides Notable exception Virginia collects info on certified nurse aides pdf healthworkforceta.org 11

12 Who Are New York s Primary Care Practitioners? Percentage of Physicians, NPs, PAs, and Midwives who Provide Primary Care Services in New York 100% 90% 80% 70% 70% 60% 50% 40% 30% 20% 28% 33% 22% 10% 0% Physicians Source: CHWS New York Re registration Surveys Nurse Practitioners Physician Assistants Midwives healthworkforceta.org 12

13 healthworkforceta.org 13 Organizations in 15 States Collect Health Workforce Demand Data WA MI CT NY MA NH RI NJ ID SD MN VT WV VA IN CA AZ NM AR DE DC MD LA MS IL KY AK TX SC NC OK NV WA MI CT NY MA NH RI NJ ID SD MN VT WV VA IN CA AZ NM AR DE DC MD LA MS IL KY AK TX SC NC OK NV AL CO FL GA HI IA KS ME MO MT NE ND OH OR PA TN UT WI WY

14 Health Workforce Demand Data Collection: Professions, Settings and Variables Most frequently targeted professionals: RNs (10 states), physicians (9 states), NPs (9 states), and LPNs (9 states) Most frequently targeted settings: hospitals (10 states) and nursing homes (8 states) Most frequently collected variables: vacancies (11 states), recruitment difficulty (10 states), turnover (9 states) and retention difficulties (4 states) healthworkforceta.org 14

15 Recruitment and Retention Issues of New York Health Care Providers Hospitals o Hard to recruit clinical laboratory technologists (CLTs) and nurse managers o Hard to retain CLTs, care coordinators and physician assistants Nursing homes o Hard to recruit experienced RNs o Hard to retain certified nurse aides Community health centers o Hard to recruit psychiatric NPs, psychiatrists o Hard to retain psychiatric NPs, medical assistants 15

16 Organizations in 19 States Collect Information About the Health Workforce Educational Pipeline WA MT ND MN OR CA NV ID UT WY CO SD NE KS IA MO WI IL IN MI KY OH WV NY PA NJ MD DE DC VA VT NH MA CT RI ME AZ NM OK AR TN SC NC TX LA MS AL GA HI AK FL healthworkforceta.org 16

17 Educational Pipeline Data Collection Strategies Educational pipeline data collection is most likely for registered nurses (13 states), physicians (11 states), and licensed practical nurses (10 states) Data collection is recurring in 17 states Data are collected from education programs in 15 states and from individuals in training in 7 states Most states report collecting information on graduations (17 states), enrollments (15 states) and the demographic characteristics of trainees (13 states) o A small number of states report collecting information on about trainees post-graduation plans (4 states) and job market experiences (1 state) healthworkforceta.org 17

18 Resident Exit Survey Tracks In-State Retention of New Physicians Who Complete Training in NY Percent of new physicians with confirmed practice plans in New York Source: CHWS New York Resident Exit Survey,

19 Nursing Deans Survey Tracks Growing Number of RN Graduations in New York 12,000 New York RN Graduations, by Degree Type, ,000 8,000 Total 6,000 Associates 4,000 Bachelor's 2, Source: CHWS Nursing Dean s Survey #

20 Thinking through State Data Collection Strategies Build collaborations Whenever possible, link data collection to existing efforts Keep it simple (e.g., MDS) Use the most cost-effective, efficient strategies for data collection Disseminate, disseminate, disseminate. Stay relevant to state-specific issues healthworkforceta.org 20

21 Seeking Input on Next Steps for the State Survey Continue to pursue states that have not responded Learn more about o Data quality (e.g., response rates) o Survey instruments o Uses of the data Tell us your thoughts on next steps healthworkforceta.org 21