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The North Carolina Health Professions Data System
The North Carolina Health Professions Data System
Overview of Todays Presentation
Overview of Todays Presentation
Our Mission
Our Mission
HPDS: 3 Main Product Lines
HPDS: 3 Main Product Lines
North Carolina HPDS
North Carolina HPDS
The System is Unique in the U.S
The System is Unique in the U.S
Categories of Health Professionals in Data System
Categories of Health Professionals in Data System
HPDS Data Collected from Boards
HPDS Data Collected from Boards
Data Items Collected
Data Items Collected
Data Items Updated
Data Items Updated
Additional Data Items Collected for Physicians and PAs
Additional Data Items Collected for Physicians and PAs
Licensure File Creation and Maintenance (continued)
Licensure File Creation and Maintenance (continued)
North Carolina Health Professions Data Book
North Carolina Health Professions Data Book
North Carolina Health Professions Data Book
North Carolina Health Professions Data Book
HPDS: Organizational Issues
HPDS: Organizational Issues
Infrastructure: Hardware/Software
Infrastructure: Hardware/Software
Dissemination
Dissemination
Basic Cost Estimates
Basic Cost Estimates
Cost Estimate for Producing the Annual Data Book: Operating Costs
Cost Estimate for Producing the Annual Data Book: Operating Costs
Examples of Sources of Funding for Workforce Research
Examples of Sources of Funding for Workforce Research
Data Request Revenue
Data Request Revenue
Data Sources
Data Sources
Examples of Secondary Data Sources
Examples of Secondary Data Sources
HPDS benefits from other data sets at Sheps
HPDS benefits from other data sets at Sheps
Why? Examples and Value of Work
Why? Examples and Value of Work
The Data System Can Help Answer Questions Like:
The Data System Can Help Answer Questions Like:
BUT it cant answer some types of questions for lack of appropriate
BUT it cant answer some types of questions for lack of appropriate
The Basics: Describing the Workforce
The Basics: Describing the Workforce
Makes analysis simple
Makes analysis simple
Informing Policy Makers
Informing Policy Makers
Trends in the Supply of Dentists in North Carolina, 1996-2005
Trends in the Supply of Dentists in North Carolina, 1996-2005
The Supply and Distribution of Psychiatrists in North Carolina:
The Supply and Distribution of Psychiatrists in North Carolina:
The North Carolina Health Professions Data System
The North Carolina Health Professions Data System
NC AHEC, Sheps, NC IOM: The Primary Care and Specialty Physician
NC AHEC, Sheps, NC IOM: The Primary Care and Specialty Physician
The Primary Care and Specialty Physician Taskforce: Supply Projections
The Primary Care and Specialty Physician Taskforce: Supply Projections
The North Carolina Health Professions Data System
The North Carolina Health Professions Data System
Wrapping Up
Wrapping Up
Giving Back to the Boards
Giving Back to the Boards
Lessons Learned
Lessons Learned
Health Workforce Planning: The Future
Health Workforce Planning: The Future
Moving Forward
Moving Forward
Recommendations
Recommendations
Contact Us
Contact Us
HPDS Website http://www
HPDS Website http://www
Extra Slides
Extra Slides
Overview
Overview
The Cecil G. Sheps Center for Health Services Research
The Cecil G. Sheps Center for Health Services Research
Data Request Process
Data Request Process
Data Request Process
Data Request Process
Data Requests Requiring Processing
Data Requests Requiring Processing
Organizational Issues: Personnel
Organizational Issues: Personnel
HPDS Benefits from Sheps Center Infrastructure
HPDS Benefits from Sheps Center Infrastructure
Infrastructure: Cartography and Geographic Analysis Capabilities
Infrastructure: Cartography and Geographic Analysis Capabilities
Infrastructure: Library Services
Infrastructure: Library Services
Infrastructure: Dissemination
Infrastructure: Dissemination
Electronic Dissemination
Electronic Dissemination
HPDS: 3 Main Product Lines
HPDS: 3 Main Product Lines
The Basics: Benchmarking
The Basics: Benchmarking
Health Professions Data System Recent Products
Health Professions Data System Recent Products
Trends in Physicians Delivering Babies
Trends in Physicians Delivering Babies
Osteopaths, relatively few, but growing fast in numbers
Osteopaths, relatively few, but growing fast in numbers
Evaluation
Evaluation
Medical Student Tracking (Class of 1996)
Medical Student Tracking (Class of 1996)
Medical Student Tracking (Class of 2002)
Medical Student Tracking (Class of 2002)
Informing Policy Makers NC AHEC  Special Requests
Informing Policy Makers NC AHEC Special Requests
Allied Health Studies
Allied Health Studies
HPDS: 3 Main Product Lines
HPDS: 3 Main Product Lines
The State of Allied Health in NC
The State of Allied Health in NC
Manufacturing and Health Care & Social Assistance Employment, NC,
Manufacturing and Health Care & Social Assistance Employment, NC,
Healthcare and Allied Health Jobs Grew, Overall Employment Remained
Healthcare and Allied Health Jobs Grew, Overall Employment Remained
North Carolinas Fastest Growing Occupations Percent Change in
North Carolinas Fastest Growing Occupations Percent Change in
Health Care Jobs in North Carolina, 2005
Health Care Jobs in North Carolina, 2005
Job Vacancy Tracking Reports
Job Vacancy Tracking Reports
Medical Assistants Employed in North Carolina, 2002-2006
Medical Assistants Employed in North Carolina, 2002-2006
Licensure File Creation and Maintenance
Licensure File Creation and Maintenance
Licensure File Creation and Maintenance (continued)
Licensure File Creation and Maintenance (continued)
Licensure File Creation and Maintenance
Licensure File Creation and Maintenance

: The North Carolina Health Professions Data System. : . : The North Carolina Health Professions Data System.ppt. zip-: 2984 .

The North Carolina Health Professions Data System

The North Carolina Health Professions Data System.ppt
1 The North Carolina Health Professions Data System

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

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

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

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

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

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

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

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

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 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

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)

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

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

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

HPDS: Organizational Issues

16 Infrastructure: Hardware/Software

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

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

Basic Cost Estimates

Stage

Funding type

Tasks

Estimate *This may vary*

Design the System

One-Time

Implement the System

One-Time

Operations

Ongoing

Special Projects

Occasional

$117,000 (North Carolina)

Explore available data, infrastructure, personnel, expectations; design database and data collection & analysis procedures

Wide range; depends on quality of data and current database format; personnel

Wide range; depends on quality of data and current database format; personnel

Hire; purchase infrastructure; collect and audit data; populate database; identify and repair glitches; launch website

Maintain files and collect new data; publish Data Book and aggregate stats; maintain website; respond to requests for data

Undertake special projects at the request of General Assembly and others; tasks determined by nature of project

Depends on scope of work and budget

19 Cost Estimate for Producing the Annual Data Book: Operating Costs

Cost Estimate for Producing the Annual Data Book: Operating Costs

Fiscal Year 2007-2008

Personnel Time (salaries and benefits) excludes project cross-subsidies

~$113,300

Administrative (copying, postage, phone, supplies)

$600

Publications (printing, dissemination)

$2,900

Total

~$116,849

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.

*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

Examples of Sources of Funding for Workforce Research

Maintenance of Licensure Data Files for HPDS

Allied Health Workforce Studies

Special Projects: Service to the State and the Institution

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

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

Data Sources

23 Examples of Secondary Data Sources

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

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

Why? Examples and Value of Work

26 The Data System Can Help Answer Questions Like:

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

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

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

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

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

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:

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 The North Carolina Health Professions Data System
34 NC AHEC, Sheps, NC IOM: The Primary Care and Specialty Physician

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

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

.75 FTE, faster growth

.5 FTE, slower growth

Ratio Relative to 2004 Level

Year

105%

100%

95%

90%

85%

80%

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

36 The North Carolina Health Professions Data System
37 Wrapping Up

Wrapping Up

38 Giving Back to the Boards

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

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

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

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

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

Contact Us

Katie Gaul k_gaul@unc.edu (919) 966-6529

Erin Fraher, Director erin_fraher@unc.edu (919) 966-5012

Tom Ricketts tom_ricketts@unc.edu (919) 966-5541

Jessica Carpenter jmcarpen@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@unc.edu

44 HPDS Website http://www

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

Extra Slides

46 Overview

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

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

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

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

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

Organizational Issues: Personnel

Deputy Director Policy Analysis Tom Ricketts, PhD

Director Health Professions Erin Fraher, MPP

Research Associate

Data Coordinator

Research Associate

Programmer

Programmer

Center Director

Deputy Director Research

Deputy Director Operations

Director Program on Primary Care & Health Professions

Associate Director Health Policy Information

Director NC Rural Health Policy Analysis

Associate Director Policy Analysis

50%

Associate Director Data Mgmt & Information Services

Programmer

100%

Programmer

100%

Research Assoc

50%

10%

Graduate RA 10hrs

Graduate RA 20 hrs

52 HPDS Benefits from Sheps Center Infrastructure

HPDS Benefits from Sheps Center Infrastructure

Health Professions Data System

Computer and Data Management Support

Executive

Other Research Areas

Administrative Support

Business and Financial Support

Programming

Media and Communications

Information and Library Services

53 Infrastructure: Cartography and Geographic Analysis Capabilities

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

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

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

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

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

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

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

Trends in Physicians Delivering Babies

2000

2001

2002

2003

2004

OB/GYNs

919

937

954

960

981

OB/GYNs Delivering

651

701

742

750

748

% OBs

70.8%

74.8%

77.8%

78.1%

76.2%

FPs

2,173

2,224

2,293

2,327

2,040

FPs Delivering

212

227

228

232

205

% FPs

9.8%

10.2%

9.9%

9.9%

10%

61 Osteopaths, relatively few, but growing fast in numbers

Osteopaths, relatively few, but growing fast in numbers

Growth rate of >10% per year

Number of DOs

400

350

300

250

200

150

100

50

0

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

62 Evaluation

Evaluation

63 Medical Student Tracking (Class of 1996)

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)

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

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

Allied Health Studies

67 HPDS: 3 Main Product Lines

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

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,

Manufacturing and Health Care & Social Assistance Employment, NC,

1995-2005

822, 995

Manufacturing

568,835

Employment (thousands)

491,637

Health Care & Social Assistance

332,446

Year

900

800

700

600

500

400

300

200

100

0

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

Source: North Carolina Employment Security Commission, 2006.

70 Healthcare and Allied Health Jobs Grew, Overall Employment Remained

Healthcare and Allied Health Jobs Grew, Overall Employment Remained

Stagnant

1999

2005

% Growth (1999-2005)

Total N.C. Employment

3,801,670

3,809,690

0.2%

Healthcare Jobs

251,550

302,270

20.2%

Allied Health Jobs

76,590

111,630

45.8%

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

North Carolinas Fastest Growing Occupations Percent Change in

Employment, 2002-2012

Rank

Occupation

Projected Openings

% Change

1

Medical Assistants

4,950

60.9

2

Occupational Therapy Aides

30

60.0

3

Dental Hygienists

2,590

53.9

4

Dental Assistants

3,120

53.0

5

Social and Human Services Assistants

5,110

48.4

6

Medical Record Tech.

2,620

48.3

7

Physical Therapist Assist.

720

47.7

8

Fitness Trainers

2,780

47.6

9

Respiratory Therapy Tech.

330

47.1

10

Respiratory Therapists

1,170

46.8

http://eslmi23.esc.state.nc.us/projections/EmploymentOutlook.asp?version=aopengp&AreaType=01&Area=000037&PeriodID=06

72 Health Care Jobs in North Carolina, 2005

Health Care Jobs in North Carolina, 2005

Allied Health Professions, 37%

Total Health Care Jobs = 302,270

Other, 3%

Physicians, 5%

LPNs, 5%

RNs, 24%

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

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 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

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)

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

Licensure File Creation and Maintenance

October

The entire process takes nearly a year from start to finish

August

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

Feedback to Boards

Generate tables of summary stats for review

File Audit: compare, investigate

Final review, approval for release

The North Carolina Health Professions Data System
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