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Health Workforce in Canada

Francine Anne RoyCanadian Institute for Health Information

Canada

International Medical Workforce Collaborative

10th Conference, Vancouver, B.C., CanadaMarch 2007


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Todays Health Workforce Through . . .

Innovations in data collection

Data modelling and planning initiatives

. . . in Canada


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Innovations in Data Collection

New partnerships

Using a mix of administrative and survey data

Expanding national supply of data collection beyondphysicians and nurses

Development of multi-profession supply databases byprovinces/territories

Health Canada projects


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Premier Source of Information Collaboration Is Key

The Canadian Institute for Health Information (CIHI)

is an independent, not-for-profit organization thatprovides essential data and analysis on Canadashealth system and the health of Canadians.

Statistics Canada

Ministries of

Health

Regional Health

Authorities

Health Facilities

Public- andPrivate-Sector

Organizations

Professional

Associations

Advocates

ResearchersHealth Canada


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Health Human Resources (HHR)Distribution of Health Personnel by Occupation in Canada, 2005

Total RegulatedNurses

43%

Physicians9%

Pharmacists3%

Midwives1%

Other Regulatedand Unregulated

Health Personnel45%

Sources: Labour Force Survey, Statistics Canada; Canadian Regulated Nurses Databases, Scotts Medical Database, CIHI, 2005.


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Age Distribution, Canada, 19802005

0%

5%

10%

15%

20%

25%


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Scotts Medical Database, 1968to 2005 (CIHI)

National Physician Database,1972 to 2004 (CIHI)

Registered Nurses Database,1980 to 2005 (CIHI)

Registered Psychiatric NursesDatabase, 2002 to 2005 (CIHI)

Licensed Practical NursesDatabase, 2002 to 2005 (CIHI)

Health Personnel Database,1970 to 2004 (CIHI)

National Physician Survey (CMA,CFPC, RCPSC)

CMA Masterfile (CMA)

National Survey of the Work andHealth of Nurses (SC)

Labour Force Survey (SC)

Canadian Community HealthSurvey (SC)

Census (SC)

CAPER (AFMC)

ORIS (AFMC)

Many others . . .

HHR Data Sources


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First survey conducted in 2004

Second wave launched January 2007 Results will start to be available in

November 2007

Introducing New Data

National Survey of the Work and Health ofNurses (NSWHN)partnership project between

CIHI, Statistics Canada and Health Canada(telephone survey completedin the fall of 2005)

Canadian Physician Health Surveyto beconducted in 2007


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Level of Satisfaction

Physicians Nurses

Source: NPS, CMA, CFPC, RCPSC, 2004; NSWHN, Statistics Canada, 2005.

Very

Dissatisfied

2%Somewhat

Dissatisfied

9%

Somewhat

Satisfied

47%

Very

Satisfied

42%Very

Satisfied

28%

Somewhat

Satisfied

45%

Somewhat

Dissatisfied

12%

VeryDissatisfied

4%

Neutral

11%


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0

20

40

60

80

100

120

140

160

180

N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C.

Total

NumberofFTE

Physicians

FFS APP

Enhancing the Collection of PhysicianPayment Data

Preliminary data: NPDB, CIHI, 2007.

FTE Physicians per 100,000 Population by Type of Payment, 2004/05


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28% 36% 45%

Performing

Surgery

ProvidingSurgical

Assistance

Delivering

Babies

16%

HospitalInpatient Care

ProvidingMental Health

Care

31%No Change

ProvidingAnesthesia

Services

Evolving Role of Fee-for-Service

Family Physicians

Source: National Physician Database, CIHI; in collaboration with Dr. Joshua Tepper.

Change

NationallyBetween 1994

and 2003


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HHR Databases Development Project

Head counts Gender

The Pharmacist Workforce -- Before


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Pharmacist hours worked

0

10

20

30

40

50

40

Based on one Canadian province only.Pharmacy Source: PDB preliminary data, CIHI

% of

Pharmacists

Hours worked


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Pharmacist hours worked and gender

0

10

20

30

40

50

60

70

40

Female MaleBased on one Canadian province only.Pharmacy Source: PDB preliminary data, CIHI

% of

Pharmacists

Hours worked


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B.C.

N.W.T./Nun.

Alta.Sask. Man. Ont.

N.L.

N.B.

N.S. 43

22

68

65375

1325

22

Nurse Practitioners, Canada, 2005


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Database Collaboration

Note: Full-time faculty includes professors, associate and assistant professors, instructors and other faculty. Part-timefaculty includes paid and volunteer faculty members. Faculty counts for 20052006 are preliminary.Sources: Office of Research and Information Services (ORIS) and Canadian Post-M.D. EducationRegistry (CAPER), Association of Faculties of Medicine of Canada, 2007.

CAPER & ORIS DATA: Faculty of Medicine Faculty Counts and

MD Students/Post-MD Trainees, Canada, 1992/93-2005/06

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

92/93 93/94 94/95 95/96 96/97 97/98 98/99 99/00 00/01 01/02 02/03 03/04 04/05 05/06

Number of Full-Time Faculty Number of Part-Time Faculty

Total MD Students + Post-MD Trainees


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Migration of Physicians

Source: Scotts Medical Database, CIHI, 2005.

0

100

200

300

400

500

600

700

1969

1971

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

Year

NumberofP

hysicians

M oving Abroad Returning f rom Abroad

Number of Physicians Who Moved Abroad orReturned From Abroad, Canada, 1969 to 2005


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Internationally Educated Physiciansand Nurses in Canada


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Collaborating With Researchers

Geographic StudiesDistribution of Physicians in Canada, 2004

Source: SMDB, CIHI, 2004; in collaboration with Dr. Raymond W. Pong and Dr. J. Roger Pitblado.

Each dot represents one physician.Less than 16% of family physiciansand 2.4% of specialists werelocated in rural and small-townCanada, where 21.1% of the

population resided in 2004.


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Moving Data From InternationalLevel . . .

2.6

2.4

2.3

2.1

0 1 2 3 4 5 6

Turkey*

Korea

Mexico

Japan

CanadaNew Zealand*

United Kingdom

Poland

Finland

United StatesAustralia*

Ireland

Luxembourg

Denmark*

Slovak RepublicHungary

SwedenFrance

Germany

PortugalSpain

Austria

Czech Republic

Norway

IcelandNetherlands

Switzerland

Belgium

Italy

Greece

Country

Physicians per 1000 PopulationSource: OECD Health Data.

OECD Physicians per 1,000 Population, 2004


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1968 = 108

1993 = 191

2005 = 190

. . . to National Level . . .Number of Canadian Physicians per 100,000 Population

Source: National Physician Database, CIHI.


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to Provincial/Territorial levelseven Regional levels.

P.E.I. and Canada Physician Counts and Per 100,000 Population Ratio's

Source: SMDB, CIHI, Population Data, Statistics Canada

# Physicians

Physicians

per

100,000

Population # Physicians

Physicians

per

100,000

Population # Physicians

Physicians

per

100,000

Population

West Prince Health Region 7 48 0 0 7 48East Prince Health Region 35 104 12 36 47 140

Queens Health Region 71 103 64 93 135 196

Kings Health Region 10 47 0 0 10 47

123 89 76 55 199 144

31633 98 29989 93 61622 190Canada

Province Region

P.E.I.

Family Medicine Specialist Total Physicians

P.E.I. Total


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Multi-Professional Databases


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Multi-Professional Databases


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Selected Health Canada Projects

Pan-Canadian health humanresources planning initiative

Jurisdictional/regional healthhuman resources projects:

Example projects:

Western and NorthernCanada project

Human resources strategy forNova Scotia Department of

Health Health human resources

strategy Manitoba


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Data Modelling and Planning Initiatives

To identify and address HHR forecasting needs, Health

Canada has committed funding to: Inventory forecasting models under development and being

used in Canada

Assess models against their scope, utility and ability to meet

needs

Determine jurisdictional forecasting needs

Identify gaps in forecasting capacity

Goal:

To share knowledge and increase

modelling capacity nationally


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Data Modelling Atlantic Canada Develop a simulation model for the Atlantic region to:

Simulate gaps in the supply of and need for HHR

Test the effectiveness of policy initiatives in dealing with HHRgaps prior to full implementation of the policy intervention.

How it works:

Estimates and compares provider supply with requirements.

NeedsModule

ProductivityModule

Training

Module

SupplyModule

Population, health status, level of service, service

requirements, activity-adjusted providers required

Productivity, worked hours, activity-adjusted providersavailable

ProviderRequirements

Seats, program attrition, program length,

number of students, graduate out-migration

Graduate entry rates, graduate age distribution,

in-migration, provider stock, exit rates

ProviderSupply


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Whats Next?


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Some Challenges

Changing environment and landscape for

health human resources

Changing environment and landscape ofprivacy legislation (e.g., data loss)

Infrastructure and systems (e.g., NUI)

Resources

Multitude of stakeholders and users =increasing and varied demands


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How to reach CIHI:

[email protected]

www.cihi.ca

[email protected]

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