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Health Workforce Policies
in OECD Countries
Right Jobs, Right Skills, Right Places
Released on March 15, 2016
http://www.o...
20
19
16
16
15
14
14
13 13 13 13
13 13
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12 11
11 11 11
10 10
9 8 8
7 7
7
7 6 6
6
6
5
4
3
0
2
4
6
8
10
12
14
16
18
20
201...
Rising numbers of health workers mean that the
“inflows” have exceeded the “outflows”
The number of doctors has increased in
nearly all OECD countries since 2000
1. Data include not only doctors providing dir...
25
30
35
40
45
50
55
60
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 201...
The number of doctors also varies widely across
regions in each country
Note: Each observation (point) represents a territ...
Key policy priorities relate to achieving better
geographic distribution and mix of doctors
* The Netherlands is the only ...
The number of nurses has also increased in nearly
all OECD countries since 2000
1. Data include not only nurses providing ...
Changes in domestic education
and training capacity
(numerus clausus policies)
Most OECD countries have increased intakes in
medical education, but at different time and pace
Source: Health Workforce P...
The increase in student intakes has led to growing
numbers of new medical graduates
Source: OECD Health at a Glance 2015
N...
Some countries are trying to steer medical
graduates into general medicine training
Source: Health Workforce Policies in O...
48% 44% 40% 37%
27% 27%
52% 56% 60% 63%
73% 73%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
General medicine Other special...
Most OECD countries have also increased
student intakes in nursing education
Source: Health Workforce Policies in OECD Cou...
The increase in student intakes has led to growing
numbers of nursing graduates, particularly in the USA
Source: OECD Heal...
The nursing workforce outlook in the USA has
changed greatly: From projected shortages to
projected surpluses
 In 2004: U...
0
50
100
150
200
250
300
350
400
Nurse practitioner (admissions)
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
Nur...
International migration
of health workers
19
The share of foreign-trained doctors varies
widely across OECD countries
Share of foreign-trained doctors in OECD count...
20
The share of foreign-trained nurses is lower than
foreign-trained doctors (but the absolute number
is higher)
Share of ...
The main origin country of foreign-trained doctors
in the two main destination countries is India
Source: OECD Health at a...
Doctors
0
4 000
8 000
12 000
16 000
20 000
24 000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Nu...
Skills use and skills
mismatch in the
health sector
Two types of skills mismatch in health sector:
under-skilling and over-skilling
Source: Health Workforce Policies in OECD ...
More than 75% of doctors and nurses report
being over-skilled for some of the tasks they do
Note: Others = workers in othe...
At same time, 50% of doctors and 40% of nurses
report being under-skilled for some tasks
Note: Others = workers in other t...
1 1
1.08
0.58
1.98
0.48
0
0.5
1
1.5
2
Overskilled Underskilled
Lower than bachelor's degree
Bachelor or equivalent
Master ...
The way forward
Three-point plan to improve
health workforce strategies
• Right jobs: Train a sufficient number and proper mix of health w...
More information
http://www.oecd.org/health/health-workforce-policies-
in-oecd-countries-9789264239517-en.htm
@OECD_Social
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Health Workforce Policies in OECD Countries - Right Jobs, Right Skills, Right Places: Chart set

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Health Workforce Policies in OECD Countries - Right Jobs, Right Skills, Right Places: Chart set (March 2016)

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Health Workforce Policies in OECD Countries - Right Jobs, Right Skills, Right Places: Chart set

  1. 1. Health Workforce Policies in OECD Countries Right Jobs, Right Skills, Right Places Released on March 15, 2016 http://www.oecd.org/health/health-workforce-policies-in-oecd- countries-9789264239517-en.htm Note: Chapter 3 and Chapter 6 have benefited from financial support from the European Commission. The contents of these chapters are the sole responsibility of the OECD and can in no way be taken to reflect the views of the European Union.
  2. 2. 20 19 16 16 15 14 14 13 13 13 13 13 13 12 12 11 11 11 11 10 10 9 8 8 7 7 7 7 6 6 6 6 5 4 3 0 2 4 6 8 10 12 14 16 18 20 2014 2000% Jobs in the health and social sector now account for more than 10% of total employment in most OECD countries Source: Source: OECD.Stat, Annual Labour Force Statistics (ALFS) and National Accounts, OECD (2016) Employment in health and social work as a share of total employment
  3. 3. Rising numbers of health workers mean that the “inflows” have exceeded the “outflows”
  4. 4. The number of doctors has increased in nearly all OECD countries since 2000 1. Data include not only doctors providing direct care to patients, but also those working in the health sector as managers, educators, researchers, etc. (adding another 5-10% of doctors). 2. Data refer to all doctors licensed to practice (resulting in a large over-estimation of the number of practising doctors in Portugal, of around 30%). Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Strong increase in countries that had low numbers, but also in some that already had high numbers 1.8 1.9 2.2 2.2 2.2 2.3 2.6 2.6 2.6 2.7 2.8 2.8 2.8 3.0 3.0 3.2 3.3 3.3 3.3 3.3 3.4 3.4 3.4 3.6 3.6 3.7 3.8 3.9 4.0 4.0 4.1 4.3 4.3 5.0 6.3 0 1 2 3 4 5 6 7 2013 (or nearest year) 2000 Per 1 000 populationPractising doctors per 1 000 population
  5. 5. 25 30 35 40 45 50 55 60 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Australia Belgium France Germany Netherlands United Kingdom OECD% But the share of generalists has come down, limiting access to primary care Note: Generalists include general practitioners (‘family doctors’) and other generalists (non-specialists). Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Only one in three doctors now in OECD countries are generalists
  6. 6. The number of doctors also varies widely across regions in each country Note: Each observation (point) represents a territorial level 2 region (for example, region in France, Länder in Germany or State in the United States) in each country. The data for Chile relate to 2009 and do not reflect the increase in the number of physicians since then. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Physician density, by Territorial Level 2 regions, 2013 Australia Austria Belgium Canada Chile Czech Rep. Denmark Estonia Finland France Germany Greece Hungary Israel Italy Japan Korea Luxembourg Mexico Netherlands New Zealand Norway Poland Portugal Slovak Rep. Slovenia Spain Sweden Switzerland Turkey United Kingdom United States 0 1 2 3 4 5 6 7 8 9 10 Density per 1 000 population Vienna Brussels Prague Athens Region Lisbon Bratislava Washington, D.C. Helsinki Copenhagen Region Mexico city
  7. 7. Key policy priorities relate to achieving better geographic distribution and mix of doctors * The Netherlands is the only country that did not indicate any particular issue about physician supply. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Issues related to physician supply, based on 31 OECD country responses, 2012 0 5 10 15 20 25 30 No issue identified* Maintaining the current level of physician supply Meeting increased demand for services Maintaining share of GPs Shortages of certain specialty areas Mal-distribution of physician supply Number of countries
  8. 8. The number of nurses has also increased in nearly all OECD countries since 2000 1. Data include not only nurses providing direct care to patients, but also those working as managers, educators, researchers, etc. 2. Chile reports all nurses who are licensed to practice (less than one-third are professional nurses with a university degree). 3. Austria reports only nurses employed in hospital. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) 1.8 2.6 3.6 4.9 5.1 5.2 5.3 5.6 5.8 6.1 6.1 6.2 6.4 7.9 8.0 8.2 8.3 9.1 9.4 9.5 9.5 10.0 10.5 11.1 11.2 11.5 11.9 12.1 12.4 13.0 14.1 15.5 16.3 16.7 17.4 0 3 6 9 12 15 18 2013 (or nearest year) 2000 Per 1 000 populationPractising nurses per 1 000 population
  9. 9. Changes in domestic education and training capacity (numerus clausus policies)
  10. 10. Most OECD countries have increased intakes in medical education, but at different time and pace Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) 75 100 125 150 175 200 225 250 France 75 100 125 150 175 200 225 250 Australia 75 100 125 150 175 200 225 250 Canada 75 100 125 150 175 200 225 250 United States Student intake in medical education (Index: Baseline year = 100)
  11. 11. The increase in student intakes has led to growing numbers of new medical graduates Source: OECD Health at a Glance 2015 Number of medical graduates has more than doubled in Australia and doubled in the UK since 2000 Source: OECD Health Statistics 2015, DOI Non-European countries European countries Nordic countries Central and Eastern European Countries 50 100 150 200 250 Australia Canada Japan United States Index (2000=100) 50 100 150 200 250 France Germany Netherlands United Kingdom Index (2000=100) 50 100 150 200 250 Finland Norway Sweden Index (2000=100) 50 100 150 200 250 Czech Republic Hungary Poland Slovak Republic Index (2000=100)
  12. 12. Some countries are trying to steer medical graduates into general medicine training Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) But it has not always been easy to attract a sufficient number of students to fill all training places Canada France 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 General Medicine (available) Specialisations (available) General Medicine (filled) Specialisations (filled) 0 250 500 750 1,000 1,250 1,500 1,750 2,000 Family medicine Other Specialisations
  13. 13. 48% 44% 40% 37% 27% 27% 52% 56% 60% 63% 73% 73% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% General medicine Other specialisations The share of students admitted in general medicine varies across countries between 25% to 50% Note: In the United States, general medicine includes students admitted to both family medicine and internal medicine. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Share of students admitted in general medicine and other specialisations, 2013 (or nearest year)
  14. 14. Most OECD countries have also increased student intakes in nursing education Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Student intake in nursing education (Index: Baseline year = 100) 50 75 100 125 150 175 200 225 250 Australia 50 75 100 125 150 175 200 225 250 Canada 50 75 100 125 150 175 200 225 250 Belgium 50 75 100 125 150 175 200 225 250 Finland
  15. 15. The increase in student intakes has led to growing numbers of nursing graduates, particularly in the USA Source: OECD Health at a Glance 2015 Evolution in the number of nursing graduates 50 100 150 200 Denmark Finland Norway Switzerland Index (2003=100) 50 100 150 200 France Germany Japan United States Index (2003=100)
  16. 16. The nursing workforce outlook in the USA has changed greatly: From projected shortages to projected surpluses  In 2004: US Department of Health and Human Services projected a shortage of almost one million registered nurses by 2020 (if student admission had remained at their 2001 level)  In 2014: US Department of Health and Human Services projected a surplus of 340 000 registered nurses by 2025 (if student admission remains at their 2013 level)
  17. 17. 0 50 100 150 200 250 300 350 400 Nurse practitioner (admissions) 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 Nurse practitioner (graduates) Some countries have also increased the number of training places for nurse practitioners (NPs) to improve access to primary care Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) United States Netherlands
  18. 18. International migration of health workers
  19. 19. 19 The share of foreign-trained doctors varies widely across OECD countries Share of foreign-trained doctors in OECD countries, 2013 (or nearest year) 1. In Germany and Spain, the data is based on nationality (or place of birth in Spain), not on the place of training. Source: OECD Health at a Glance 2015
  20. 20. 20 The share of foreign-trained nurses is lower than foreign-trained doctors (but the absolute number is higher) Share of foreign-trained nurses in OECD countries, 2013 (or nearest year) 1. Data for some regions in Spain relate to foreign nationality or place of birth, not the place of training. Source: OECD Health at a Glance 2015
  21. 21. The main origin country of foreign-trained doctors in the two main destination countries is India Source: OECD Health at a Glance 2015 United States, 2013 United Kingdom, 2014
  22. 22. Doctors 0 4 000 8 000 12 000 16 000 20 000 24 000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number Domestic graduates Foreign-trained Nurses 0 20 000 40 000 60 000 80 000 100 000 120 000 140 000 160 000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number Domestic graduates Foreign-trained The number of domestic graduates exceeds the inflows of foreign-trained doctors and nurses in the US and the UK Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) United States Sources: UK Graduate Output 1991/92 to 2012/13, Health and Doctors 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number Domestic graduates Foreign-trained Nurses 0 5 000 10 000 15 000 20 000 25 000 30 000 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number Domestic graduates Foreign-trained United Kingdom
  23. 23. Skills use and skills mismatch in the health sector
  24. 24. Two types of skills mismatch in health sector: under-skilling and over-skilling Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016)
  25. 25. More than 75% of doctors and nurses report being over-skilled for some of the tasks they do Note: Others = workers in other technical and professional occupations (ISCO 2 and 3). The figure depicts percentage responses with the associated 95% confidence interval. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Physicians Nurses Others Reported over-skilling by physicians, nurses and other occupations, PIAAC Survey, 2011-12
  26. 26. At same time, 50% of doctors and 40% of nurses report being under-skilled for some tasks Note: Others = workers in other technical and professional occupations (ISCO 2 and 3). The figure depicts percentage responses with the associated 95% confidence interval. Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) 0% 10% 20% 30% 40% 50% 60% Physicians Nurses Others Reported under-skilling by physicians, nurses and other occupations, PIAAC Survey, 2011-12
  27. 27. 1 1 1.08 0.58 1.98 0.48 0 0.5 1 1.5 2 Overskilled Underskilled Lower than bachelor's degree Bachelor or equivalent Master or equivalent Highly-qualified nurses are much more likely to report being over-skilled, suggesting a waste in human capital Source: Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places; OECD (2016) Skills mismatch among nurses by level of education, PIAAC, 2011-12 (Multinomial logistic regression, odds ratios)
  28. 28. The way forward
  29. 29. Three-point plan to improve health workforce strategies • Right jobs: Train a sufficient number and proper mix of health workers to meet future needs, without unduly relying on the training efforts of other countries, particularly those suffering from acute shortages • Right skills: Ensure that health workers acquire the right skills and competences and are given opportunities for adapting their skills during the working life to deliver high-quality health services in more team-based and patient-centred approaches • Right places: Provide everyone with adequate access to health care regardless of where they live, by promoting a more even geographic distribution of health workers through financial incentives or regulations, and making greater use of innovative health service delivery models, notably telemedicine
  30. 30. More information http://www.oecd.org/health/health-workforce-policies- in-oecd-countries-9789264239517-en.htm @OECD_Social

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