community taxonomies (cphi, cihi) roger pitblado denis heng irene koren mobility of healthcare...
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Community Taxonomies (CPHI, CIHI)Roger Pitblado
Denis HengIrene Koren
Mobility of Healthcare Providers (HHR, CIHI)Roger Pitblado
CPHA Annual ConferenceHalifax, 2008
Canada’s Rural Communities: Understanding Rural Health and Its Determinants
Census(28 variables)
– Demography –Income and Housing affordability–Dependency ratios
CCHS(29 variables)
– Self perceived health status– Use of health care services– Health behaviours
Non-CCHS
(31 variables)
– Death rates due to cancers– General mortality rates– Life expectancy, PYLL, etc.
61.8
41.8
30.2
52.3
-10.5
37.9
30.2
23.3
-14.0
-26.3
22.3
3.8
-19.3
0.5
-11.4
0 200 400 600 800 1000
Medical sonographers
Audiologists/Speech-language pathologists
Respiratory therapists
Occupational therapists
Medical radiation technologists
Dental hygienists and therapists
Physiotherapists
Dentists
Medical laboratory technologists
Medical laboratory technicians
Pharmacists
Dental assistants
Licensed practical nurses
Physicians
Registered nurses
Number per 100,000 Population
Healthcare Provider to Population Ratios, Canada 2001(Bar figures indicate percentage changes in the ratios since 1991)
750
1,250
1,750
2,250
2,750
3,250N.L
.
P.E
.I.
N.S
.
N.B
.
Que
.
Ont
.
Man
.
Sas
k.
Alta.
B.C
.
Y.T
.
N.W
.T.
Can
ada
Num
ber pe
r 100,0
00 P
opul
atio
n
Other
Technical
Dental
Rehabilatative
Pharmacists
Physicians
Nurses
“Compositional” Healthcare Provider to Population Ratios by Province/Territory and Canada, 2001
“There has been, in fact, very little progress in the comprehensive measurement of the health workforce since the 1964 Hall report.” Haddad and Scully 2002 HealthcarePapers.
“How many regulated and unregulated health care providers move each year and what is the impact of their migration on health care services?” CIHI 2001 Canada’s Health Care Providers.
“Within Canada, inter-provincial migration is not a big concern, although the urban-rural balance is.” Priest, What’s Ailing Our Nurses? CHSRF 2006.
“.. a majority of RNs whose migration is associated with going to school after their initial nursing education, do not return to the jurisdiction where they were first registered.” Pitblado et al. 2005 CJNR.
“In the midst of one of Nova Scotia’s worst health-care labour disputes, disgruntled lab technologists flocked yesterday to the welcoming arms of an Alberta recruiter.” 2001 Canadian Press article, The Globe and Mail.
“Recruitment and retention strategies are being pursued by every province as they grapple with chronic shortages of physicians (both GPs and specialists), nurses, radiation technologists and other professionals. Provincial health ministers are openly complaining about bidding wars between provinces over a dwindling resource pool, with everyone trying to outdo the other with signing bonuses and other contractual bells-and-whistles.” July 28, 2000 Health Edition.
Physician Rural-Urban Migration Counts and Rates
1986 - 1991 1991 - 1996 1996 - 2001Non-movers (Counts)RST 3,092 3,399 3,673LUC 35,290 40,513 43,023
Internal migrants (Counts)RST to LUC 783 821 1,017LUC to RST 417 650 628
Total net-migration to RST -366 -171 -389Migration Rates (%) RSTIn-migration rate 10.8 15.4 13.4Out-migration rate 20.2 19.5 21.7
Net-migration rate -9.4 -4.1 -8.3Source: SMDB, CIHI.
General population -0.0 1.4 -0.9Source: Census of Population, Statistics Canada.
Migration Counts and RatesCensus Migration Periods
All health occupations 0.3 -0.6 0.3
Physician Rural-Urban Mobility
Net-Migration Rates for Large Urban Centre (LUC) and Rural and Small Town (RST) Areas
-3.0
-2.5
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
1.5
8687
8788
8889
8990
9091
9192
9293
9394
9495
9596
9697
9798
9899
9900
0001
0102
0203
0304
1-Year Migration Periods
Net
-mig
ration R
ate
(%)
RST Net-Migration LUC Net-Migration
RST Net-migration By Age Group
To
tal
To
tal
To
tal
20-2
9
20-2
9
20-2
9
30-3
9
30-3
9
30-3
9
40-4
9
40-4
9
40-4
9
50-5
9
50-5
9
50-5
9
60+
60+
60+
-12.0
-10.0
-8.0
-6.0
-4.0
-2.0
0.0
2.0
4.0
6.0
8.0
1986-1991 1991-1996 1996-2001
Mig
rati
on
Rat
e (%
)
All healthcare occupational groups.
-12 -9 -6 -3 0 3 6 9 12 15
Registered nurses
Licensed practical nurses
Medical laboratory technologists
Audiologists/Speech-language pathologists
Physiotherapists
Dentists
Dental assistants
Pharmacists
Physicians
RST Net-Migration Rates (%)
1986-1991 1991-1996 1996-2001
Rural and Small Town Canada Net Migration Rates for Selected Healthcare Occupational Groups for Three 5-Year Mobility Periods
-0.6
-0.4
-0.1
1.7
1.9
0.8
0.6
-4.6
1.6
1.1
-1.0
2.2
-1.1
-1.6
0.0
-2.0
0 5 10 15 20 25 30
Registered nurses
Licensed practical nurses
Medical laboratory technologists
Medical laboratory technicians
Respiratory therapists
Medical radiation technologists
Medical sonographers
Audiologists/Speech-language pathologists
Physiotherapists
Occupational therapists
Dentists
Dental hygienists and therapists
Dental assistants
Pharmacists
Physicians
General population
Percentage Rural
Proportions of Healthcare Workforces Found in RST 2001
(Bar figures indicate absolute changes in the proportions since 1991)