The Health Care Human Resource Crunch
The shortage of health human resources (HHR) has been described by leaders and decision makers in health as the most important health issue in their countries. In 2006, the World Health Organization estimated there were close to 60 million full-time, paid health workers worldwide. While this seems like a large enough number to ensure we have plenty of well trained providers, there is actually a chronic global shortage of health workers.
In Canada, approximately 1 in 10 working Canadians are employed in health and social services and for the past several years the number of health professionals has been increasing. While this is encouraging, aging populations and an increase in chronic diseases are placing new demands on a health workforce that is already inadequate in number and itself aging.
The HHR crunch in Alberta can provide of sense of the urgency behind the shortage of both physicians and nurses. Estimates indicate that given our current approach to health care management, Alberta is currently short more than 1,000 family physicians. In Alberta’s largest city, Calgary, an estimated 1 in 4 people do not have a family physician. By 2016, it has been projected that Alberta will require an additional 1,800 physicians and 6,200 nurses. Alberta will be short more than 15,000 health providers in all categories by 2016 despite the fact that in 2004-2005 almost 15,000 students were enrolled in universities and colleges to study health programs.
Common Approaches to Growing Canada’s Health Human Resources
Train More People
Between 1996 and 2005, the supply of virtually all health care professionals in Canada increased; however, in many professions the increase in supply has not met population growth. Making up the shortfall through training requires significant investment. Additionally, the multi-year training cycle for many health care professions means it is many years before increasing enrollment impacts supply.
Migration from other jurisdictions is one way to build Canada’s health workforce, however, it likely is not the solution. There is a global shortage of health workers and while migration may ease the shortage in one region, it inevitably worsens the shortage in another region. In addition, barriers in licensing, regulation, and language all limit the opportunities for the migration of health workers.
Maximize Current Workforce
There is no longer a mandatory retirement age for nurses or physicians in Canada, however, the demands of many health care professions mean that some people in the professions retire earlier than the age of traditional age of 65. For example, research is indicating that an increasing portion of RN’s are retiring early at around age 56. The impact of absenteeism on the health work force is also significant. It is estimated that in Canada the absenteeism rates for nurse supervisors and registered nurses is an equivalent of 9,754 full time nursing jobs annually. Finally, the practice patterns of health care professionals impact the overall supply of health services. Factors that define practice patterns may include the number of years, days, hours a physician practices medicine, as well as, the number and type of patients treated.
One of the most powerful predictors of demand on health human resources is the overall population health. The utilization of hospital, family physician and specialist services by persons with chronic conditions is substantially higher than for those without chronic disease. Being overweight or obese is an important contributor to chronic disease. The number of overweight men, women, and children has been rising in Canada and currently more than 60 percent of Canadians are overweight or obese.
To simply expect to add more health care providers is unattainable demographically and unsustainable economically. There are clear signs that fundamental change will be necessary to maintain an adequate, healthy and satisfied health care workforce. Now it is time to turn our attention to thinking about some of the solutions. The next paper will continue the conversation by presenting some ideas and examples of changes that might contribute to building a sustainable health care system.Download
White Paper Three - The Health Care Human Resource Crunch