health workforce now and tomorrow urgent matters
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Health Workforce Now and Tomorrow Urgent Matters. Delaware Health Care Commission December 1, 2011. International Comparison of Spending on Health, 1980–2008. Average spending on health per capita ($US PPP). Total expenditures on health as percent of GDP. - PowerPoint PPT PresentationTRANSCRIPT
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Health WorkforceNow and Tomorrow
Urgent Matters
Delaware Health Care Commission
December 1, 2011
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International Comparison of Spending on Health, 1980–2008
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United StatesNorwaySwitzerlandCanadaNetherlandsGermanyFranceDenmarkAustraliaSwedenUnited KingdomNew Zealand
Average spending on healthper capita ($US PPP)
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1980
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United StatesFranceSwitzerlandGermanyCanadaNetherlandsNew ZealandDenmarkSwedenUnited KingdomNorwayAustralia
Total expenditures on healthas percent of GDP
Source: OECD Health Data 2010 (June 2010).
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Number of Practicing Physiciansper 1,000 Population, 2006
3.8 3.8
3.53.4
3.3
2.8
2.52.4
2.32.1
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Netherlands Switzerland Germany France OECD
Median
Australia* United
Kingdom
United
States
New
Zealand
Canada
*2005
Source: OECD Health Data 2008, “June 2008.”
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Federal Snapshot
• AAMC projects 91,500 physician shortage by 2020
• COGME projects 85,000 shortage by 2020
• HRSA: demand will outstrip supply
• Nearly 40% doctors over 55 – economists say 1/3 could retire in next 10 years
• More women physicians – work fewer hours
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Federal Snapshot
• RN’s over 50: 2000 2008– % total RN’s 33% 44.7%
• 157,000 pharmacy shortage -2020*
• Faculty shortages: nursing & pharmacy
• Demographics do not reflect population
• *Health Resources and Services Administration
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Delaware Snapshot
• 2,255 Est. physicians active practice
• 863 Est. pcp: 1 pcp to 1187 people
• Federally designated shortage areas: all Kent & Sussex & portions NCC– Meet or exceed 3500 to 1 ratio– COGME low end of acceptable – 1250 to 1
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Delaware Snapshot
• DE Healthcare Assn– 7900 nurses and allied professional between 2009 -
2014
• 1 to 9582 - Psychiatrist to population ratio
• 80% bachelor’s program report faculty shortage• Average faculty age (2006)
– 46 – diploma, certificate, associates– 53 – bachelor and graduate
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PCP – DE Age Distribution
PCP ‘08 DE ‘08 DE 2020 DE 2030
Under 40 19% 19% 19% 17%
40-49 29.2% 14.9% 11% 12%
50 – 64 35.4% 19% 20% 17%
Over 65 16.3% 14% 19% 24%
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PCP – DE Race Distribution
• Caucasian– PCP ’08 73% DE 2030 72%
• Asian– PCP ’08 20.%% DE 2030 .04%*
• African American– PCP ’08 4.5% DE 2030 23.5%
• Other– PCP ’08 1.2% DE 2030 .04%
– * Population Consortium does not separate Asian from “other”
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Hispanic & Non-Hispanic
Hispanic Non-Hispanic
• PCP ’08 4.2% 95.8%
• DE ’08 6% 94%
• DE 2020 10% 90%
• DE 2030 12.5% 87.5%
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Primary Care: WHY IT MATTERS
• Aging “Boomers” will create more demand for services
• Increased insured from ACA
• Increased rates of chronic illness
• Proven efficiency; cost effective; better outcomes
• Adequate supply critical to insuring access and maintain healthy populations
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Primary Care Challenges
• Medical School Debt $145,000 - $180,000• Annual Compensation:
– Orthopedics $473,770– Radiology $468,594– Dermatology $385,088– Pediatrics $192,000– Family Medicine $183,999– Geriatrics $179,950
• “ROAD” to success
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DHCC Strategies• DIMER DE Institute Medical Education & Research
– 20 slots Jefferson Medical College– 6 slots Phil. College Osteopathic Medicine
• DIDER – Delaware Institute Dental Education & Research– Dental residency support – CCHS– 5 slots Temple Univ. Kornberg School of Dentistry
• Loan Repayment– Repay undergraduate and graduate education debt – Must locate in federally designated under-served area
• Workforce Development
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SLRP Gets Results!
• 78 total
• 46 physicians
• 12 nurses
• 20 dentists
• 5 left after service
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Looking Ahead -
• Patient Centered Medical Home– Payment Reform– Scope of Practice
• Accountable Care Organizations– Team approach – best care, less spending– Evidence based medicine
• Technology – health information exchanges and electronic medical records
• Incentives – Loan Repayment
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CONTACT INFORMATIONPaula K. Roy
Executive Director
Delaware Health Care Commission
Margaret O’Neil Building
410 Federal St. Suite 7
Dover, DE 19901
302-739-2730
302-739-6927 fax
www.dhcc.delaware.gov