The North Carolina Health Professions Data System Katie Gaul, Erin Fraher, Thomas C. Ricketts, Jessica Carpenter University of North Carolina at Chapel

The North Carolina Health Professions Data System

Katie Gaul, Erin Fraher,Thomas C. Ricketts, Jessica Carpenter

University of North Carolina at Chapel Hill

Overview of Today’s Presentation


Mission Background Data Collection, Cleaning, Reporting Organizational Issues External Data Sources WHY? Examples and Value of Work Wrapping Up

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

HPDS: 3 Main Product Lines

Maintenance of Licensure Data Files for HPDS

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.

Special Projects:Service to the State and the

InstitutionThe 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.

Allied Health Workforce Studies

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 Governor’s office, the legislature, and other state agencies are working to develop innovative ways to transition unemployed individuals into allied health jobs.

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 boards—there 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.

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

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)

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)

Data Items Collected

Demographic data: Data elements that usually don’t 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)

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)

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)

Licensure File Creation and Maintenance (continued)

Data come in

Edits, cleaning

Review for changes

Formattedinitial analysis file

Trial Posts to web

Data Book released

News Release

OctoberOctober AugustAugust

The entire process takes The entire process takes nearly a year from start to nearly a year from start to

finishfinish

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

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)

HPDS: Organizational Issues

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

Dissemination

State-Level (examples) State Legislators, Governor’s 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

Basic Cost Estimates

StageFunding type

TasksEstimate

*This may vary*

Designthe System

One-Time

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

Implementthe System

One-Time

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

Operations Ongoing

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

$117,000 (North

Carolina)

Special Projects

Occasional

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

Depends on scope of work and budget

Cost Estimate for Producing the Annual Data Book:

Operating Costs

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

Fiscal Year 2007-2008

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 don’t take into account other projects that we design with the NC AHEC Program and others.

Examples of Sources of Funding for Workforce

Research Maintenance of Licensure Data Files for HPDS

Annual ContractCurrent Year, $116,849 NC AHEC Program


Institution

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)

Allied Health Workforce

Studies

Multi Year ContractTotal 2001-2007 $262,476 (Duke Endowment and NC AHEC)

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

Data Sources

Examples ofSecondary 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

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)

Why?Examples and Value of

Work

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 NC’s 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 Carolina’s citizens?

BUT it can’t 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.

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

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

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

Trends in the Supply of Dentists in North Carolina,

1996-2005Policy Issue : Dental access in rural NCKey Findings:NC lags behind national supplyBetween 1996-2005, 33% of counties experienced decline in dentists per 10K pop, 26 of 33 were rural countiesAging dental workforce, especially in rural counties87% of dentists are whitePolicy ResponseLegislature appropriated $89.6 million for new dental school at ECU and $96 million For expansion at UNC-CH

February 2007

The Supply and Distribution of Psychiatrists in North Carolina:

Pressing Issues in the Context of Mental Health Reform

Policy Issue: State decentralizing mental health services—will 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

Psychiatric Hospital (4)

Change in Psychiatrist FTEs per 10,000 Population(# of Counties)

50% or Greater Increase (9)1% to 49% Increase (22)1% to 49% Decrease (41)

50% to 99% Decrease (7)Lost all Psychiatrists (5)No Psychiatrists in 1999, At Least 1 in 2004 (4)No Psychiatrists in 1999 or 2004 (12)

Change in Psychiatrist Full-Time Equivalents per 10,000 PopulationNorth Carolina, 1999 to 2004

*Psychiatrists include active (or unknown activity status), instate, nonfederal, non-resident-in-training physicians who indicate a primary specialty of psychiatry,child psychiatry, psychoanalysis, psychosomatic med, addiction/chemical dependency,forensic psychiatry, or geriatric psychiatry, and secondary specialties in psychiatry, child psychiatry and forensic psychiatry.

Produced by: North Carolina Health Professions Data System and theSoutheast Regional Center for Health Workforce Studies, Cecil G. ShepsCenter for Health Services Research, University of North Carolina at Chapel Hill.

BroughtonHospital

John UmsteadHospital

CherryHospital

Dorothea DixHospital

Source: LINC, 2005; North Carolina Health Professions Data System, with data derived from the North Carolina Medical Board, 2004; NC DHHS, MHDDSAS, 2005.

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

The Primary Care and Specialty Physician Taskforce: Supply

Projections

80%

85%

90%

95%

100%

105%

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

Year

Rat

io R

elat

ive

to 2

004

Lev

el

.5 FTE, slower growth

.75 FTE, faster growthKey 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

Wrapping Up

“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)

Lessons Learned

Data driven workforce analyses necessary to: Monitor longitudinal trends in supply and

distribution—establish 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…)

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 states—most policy levers are at state-level

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

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 you’re looking to do will inform state policy = look for some state money to fund this (don’t depend solely on federal funding sources)

Stay objective and maintain credibility

Contact Us

Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel Hill725 Martin Luther King Jr. Blvd, CB 7590

Chapel Hill, NC 27599HPDS Main Line: (919) 966-7112, [email protected]

Tom [email protected]

(919) 966-5541

Erin Fraher, Director

[email protected](919) 966-5012

Katie [email protected](919) 966-6529

Jessica Carpenter

[email protected](919) 843-3402

HPDS Websitehttp://www.shepscenter.unc.edu/h

p 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

Extra Slides

Overview


Background Organizational Issues Data Sources Special Reports and Projects Allied Health WHY? Examples and Value of Work Wrapping Up

Contact Information

The Cecil G. Sheps Centerfor 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

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) Requestor’s name & contact information Detailed description of request Output type Due date – date sent

Data Request Process

Two types of data requests:1. 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)

2. 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

Data Requests Requiring Processing

Requests tracked in contact database (MS Access) Requestor’s 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 Director’s discretion

Organizational Issues: Personnel

Center Director

Deputy DirectorResearch

Deputy DirectorDeputy DirectorOperationsOperations

Deputy DirectorDeputy DirectorPolicy AnalysisPolicy AnalysisTom Ricketts, Tom Ricketts,

PhDPhDDirectorProgram on Primary Care &

Health Professions

Associate DirectorHealth Policy Information

DirectorNC Rural Health Policy Analysis

Associate DirectorPolicy Analysis

DirectorHealth

ProfessionsErin Fraher,

MPP

50%

Associate DirectorData Mgmt &

Information Services

Programmer

Programmer

Research Assoc

Research Associate100%Data

Coordinator100%

Programmer Programmer50% 10%

Graduate RA 10hrs Graduate RA 20 hrs

Research Associate

HPDS Benefits from Sheps Center Infrastructure

Administrative Support

Programming

Information and Library Services

Media and Communications

Business and Financial Support

Computer and Data

Management Support

Executive

Other Research

AreasHealth ProfessionsData System

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 ESRI’s 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

Infrastructure: Library Services

Sheps employs two full-time librarians who oversee the Center’s 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)

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

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








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?

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

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%

Osteopaths, relatively few, but growing fast in

numbers

Growth rate of >10% per year

0

50

100

150

200

250

300

350

400

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

379 practicing in NC2.2% of Total Physician Supply

Nu

mb

er

of

DO

s

Evaluation

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: Wake Forest University SOM Office of Student AffairsAssociation of American Medical Colleges

N.C. Medical Board

Duke Office of Medical EducationUNC-CH Office of Student AffairsECU Office of Medical EducationAmerican Medical Association Compiled by:

N.C. AHEC ProgramCecil G. Sheps Center for Health Services Research

School

Total Number of 1996 Graduates

in Training or Practice as of

2001

Number of 1996 Graduates in Training or

Practice with an Initial Residency

Choice of Primary Care

Percent of 1996 Graduates in Training or

Practice with an Initial Residency

Choice of Primary Care

Number of 1996 Graduates in Training or

Practice in Primary Care Patient

Practice as of 2001

Percent of 1996 Graduates in Training or Practice in

Primary Care Patient Practice

as of 2001

Duke 99 49 49% 34 34%

ECU 68 49 72% 38 56%

UNC-CH 156 102 65% 73 47%

Wake Forest 96 68 71% 52 54%

Medical Student Tracking(Class of 2002)

*Primary Care = Family Medicine, General Pediatric Medicine, General Internal Medicine, Internal Medicine/Pediatrics, and obstetrics/gynecology.

Sources: Wake Forest University SOM Office of Student AffairsAssociation of American Medical Colleges

N.C. Medical Board

Duke Office of Medical EducationUNC-CH Office of Student AffairsECU Office of Medical EducationAmerican Medical Association Compiled by:

N.C. AHEC ProgramCecil G. Sheps Center for Health Services Research

SchoolTotal Number of 2002 Graduates

Number of 2002 Graduates not

Entering Residency

Training

Number of 2002 Graduates Entering Residency Training

Number of 2002 Graduates Entering

Residency Training Who

Chose A Primary Care Residency

Percent of 2002 Graduates Entering

Residency Training Who

Chose A Primary Care Residency

Duke 88 0 88 40 45%

ECU 71 0 71 44 62%

UNC-CH 151 6 145 76 52%

Wake Forest 96 2 94 46 49%

North Carolina Medical Students-Initial Choice of Primary Care*2002 Graduates

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

Allied Health Studies








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: PendingWe have requested funding for continued

monitoring of allied health workforce

May 2005

Manufacturing and Health Care & Social Assistance Employment,

NC, 1995-2005

0

100

200

300

400

500

600

700

800

900

Em

plo

ym

en

t (t

hou

san

ds)

568,835

822, 995

491,637

332,446

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Year

Manufacturing

Health Care & Social Assistance

Source: North Carolina Employment Security Commission, 2006.

Healthcare and Allied Health Jobs Grew,

Overall Employment Remained Stagnant

Source: Bureau of Labor Statistics. Occupational Employment Statistics. State Cross-Industry Estimates: 1999-2005. URL: http://www.bls.gov/oes/. Accessed 06/28/2006.

1999 2005% Growth

(1999-2005)

Total N.C. Employme

nt3,801,670 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

North Carolina’s 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

Health Care Jobs in North Carolina, 2005

Other, 3%Physicians, 5%

LPNs, 5%

RNs, 24%

Nurse aides, orderlies and attendants, 26%

Allied Health Professions,

37%

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/.

Total Health

Care Jobs =

302,270

Job Vacancy Tracking ReportsPurpose: 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 2007August 2006

April 2005

Medical Assistants Employed in

North Carolina, 2002-2006

Source: North Carolina Health Professions Data System with data from the Employment Security Commission

6,6607,260

8,120

9,950

8,880

0

2,000

4,000

6,000

8,000

10,000

12,000

2002 2003 2004 2005 2006

Year

# o

f m

ed

ica

l as

sis

tan

ts

Medical assistants are growing at nearly double the projected growth rate

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

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

Licensure File Creationand Maintenance

Compare variablesreceived to previous

year’s variables

Generate tablesof summary stats

for review

Files receivedfrom Boards,

effective Oct. 31

Applications analystprogrammers

clean and edit files

Code individualsto county based

on ZIP code

File Audit:compare, investigate

Final review,approval for release

Feedback toBoards

Release Data Book,Post data to web The entire process The entire process

takes nearly a year takes nearly a year from start to finishfrom start to finish

OctoberOctober

AugustAugust

Documents

The North Carolina Health Professions Data System Katie Gaul, Erin Fraher, Thomas C. Ricketts, Jessica Carpenter University of North Carolina at Chapel