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Health Workforce Now and Tomorrow Urgent Matters

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.

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Health Workforce Now and Tomorrow Urgent Matters

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  1. Health WorkforceNow and TomorrowUrgent Matters Delaware Health Care Commission December 1, 2011

  2. International Comparison of Spending on Health, 1980–2008 Average spending on healthper capita ($US PPP) Total expenditures on healthas percent of GDP Source: OECD Health Data 2010 (June 2010).

  3. Number of Practicing Physiciansper 1,000 Population, 2006 *2005 Source: OECD Health Data 2008, “June 2008.”

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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%

  9. 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”

  10. 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%

  11. 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

  12. 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

  13. 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

  14. SLRP Gets Results! • 78 total • 46 physicians • 12 nurses • 20 dentists • 5 left after service

  15. 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

  16. CONTACT INFORMATION Paula 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 Paula.roy@state.de.us www.dhcc.delaware.gov

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