Http:// Demographic Review of the Texas Health Professions Workforce Brian King, Program Director,...

http://www.dshs.state.tx.us/CHS/hprc/

Demographic Review of theTexas

Health Professions Workforce

Brian King, Program Director, HPRC

Health Professions Resource Center

Center for Health Statistics

Texas Department of State Health Services

Texas Race/Ethnicity and Gender Demographics

2000 2008

Male 49.6% 50.1 %

Female 50.4% 49.9 %2000 Data from US Census

2008 Data from the Texas State Data Center, Migration Scenario 2, 9/2/06

Prepared By: Health Professions Resource Center, Center for Health Statistics, Texas Department of State Health Services, August 2009

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1995 1997 1999 2001 2003 2005 2007

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White Black Hispanic Other

Direct Patient Care PhysiciansFacts at a Glance – 2008

Direct Patient Care Physicians:

Total – 38,387

White 65.0%Black 4.7%Hispanic 11.6%Other 18.7%

Male 74.3%Female 25.7%

Providers/100,000 Population:Texas 158.8Border Urban 106.7Non-Border Urban 176.7Border Rural 50.1Non-Border Rural 91.2

Number of counties with no Direct Patient Care Physicians – 25

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1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007

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1990 1992 1994 1996 1998 1998 2000 2002 2004 2006 2008

DPC Physicians per 100,000 Population

DPC Physicians: Median Ages


Primary Care PhysiciansFacts at a Glance – 2008

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1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007

Primary Care Physicians:

Total – 16,528




Number of counties with no Primary Care Physicians – 27

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1994 1996 1998 2000 2002 2004 2006 2008

PC Physicians per 100,000 Population

PC Physicians: Median Ages


Primary Care Physician Demographic Trends

Race/Ethnicity Trendspercent of total

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1995 1997 1999 2001 2003 2005 2007

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Supply Ratio Trends by Race/Ethnicity

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1995 1997 1999 2001 2003 2005 2007

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Prepared By: Health Professions Resource Center, Center for Health Statistics, Texas Department of State Health Services, August 5, 2009

As of April 2009 there were 118 Whole County Health Profession Shortage Areas (HPSAs) for primary care, and 109 sub-county geographic or special population HPSAs in Texas.

Whole county HPSAs are predominately in rural counties and sub-county HPSAs are predominately in urban counties.

5,245,681 people lived in HPSAs.

More people live in Partial County HPSAs than Whole County HPSAs

It was estimated that 542 primary care physicians would have been needed to alleviate the mal-distribution.

Physician Distribution – A Type of Shortage!

Federally Designated Health Professional Shortage Areas (HPSAs) Texas

April 2009

Designation StatusNot DesignatedSpecial PopulationPartial CountyWhole County

Ratio needed to qualify – 3,500:1Texas 2009 ratio – 1,478:1

2009 Harris Ratio with 3,059 physicians = 1,313:1# Physicians for 3,500:1 ratio = 1,146

Harris could lose 1,913 physicians and not qualify as shortage area

Examples of Mal-distributionExamples of Mal-distribution

There are several cases in Texas where counties of similar size have very different supply

(in 2008):

• Nolan County had 15,813 people and 14 physicians for a ratio of 1,130:1 • Karnes County had 15,969 people but only 4 physicians for a ratio of 3,992:1 • Burnet County had 42,252 people and 33 physicians for a ratio of 1,280:1 • Waller County had 42,816 people but only 3 physicians for a ratio of 14,192:1 - the highest ratio in the state

• Angelina County had 84,171 people and 68 physicians, for a ratio of 1,238:1• Orange County had 84,937 people and 28 physicians, for a ratio of 3,033:1

• There were 27 counties with no physicians, the largest being Duval County with 13,756 people. • Terrell County was the smallest county with a physician, population 1,101.

Physician Assistant Facts – 2008

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1991 1993 1995 1997 1999 2001 2003 2005 2007

Physician Assistants:

Total – 4,191




Number of counties with no Physician Assistants – 63

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1998 2000 2002 2004 2006 2008

Physician Assistants per 100,000 Population

Physician Assistants: Median Ages


Females became the majority in 2002

Physician Assistant Demographic Trends

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1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

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Feminization of Workforce

Studies show:

• Females work fewer hours than Males, and are more likely to work part-time

• Females often take more leave, but often retire later in life

• Females tend to spend more time with patients, but then see fewer patients

• Females less likely to practice in Rural areas

May need more supply to counter fewer FTEs

http://www.dshs.state.tx.us/CHS/hprc/Publications

Note: Some licensing boards in Texas do not collect information on Gender

Dentists:

Total – 8,987

No race/ethnicity data available; in the future should be collected by new Minimum Data Set



Number of counties with no Dentists – 46

*Excludes specialistsGeneral Dentist* Facts – 2008

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1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

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1993 1995 1997 1999 2001 2003 2005 2007

General Dentists per 100,000 Population

General Dentists: Median Ages


Dental Health Professional Shortage Areas

As of January 1, 2009 there were 82 Whole County Dental Health Profession Shortage Areas (HPSAs), and 50 sub-county geographic or special population HPSAs in Texas.

Federally Designated Dental HealthHealth Professional Shortage Areas (HPSAs)

January 1, 2009

Designation StatusNot DesignatedSpecial Population Partial County Whole County


Minimum Data Set

In 2007, the 80th Session of the Legislature passed Senate Bill 29, which calls for the creation of a Minimum Data Set for the collection of information on health professionals by the Statewide Health Coordinating Council (SHCC).

Purpose: To standardize the types of information collected by the various health professions licensing boards, and to allow the SHCC, through HPRC, to gather more information on practice location, gender, age, and race/ethnicity.

Limitations: • Providers are not required to provide demographic data• Legislation does not cover all professions• Delays for some professions in collecting data (only approximately 55% covered, although others may voluntarily submit data; approximately 65% of professions expected to provide demographic data; most of those that aren’t covered or that will be delayed are Allied Health professions

and Mental Health professions)

Registered Nurse Facts - 2008

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1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

Registered Nurses:

Total – 162,304




Number of counties with no Registered Nurses – 3

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1999 2000 2001 2002 2003 2004 2005 2006 2007 2008


Registered Nurses per 100,000 Population

Registered Nurse: Median Ages

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Registered Nurse Demographic Trends




Pharmacist Facts - 2008

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2000 2001 2002 2003 2004 2005 2006 2007 2008

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1991 1993 1995 1997 1999 2001 2003 2005 2007

Pharmacists:

Total – 18,623




Number of counties with no Pharmacists – 27


Pharmacists per 100,000 Population

Pharmacist: Median Ages

Mental Health Professions

Licensed Professional Counselors

Licensed Chemical Dependency Counselors

Marriage and Family Therapists

Psychiatric Nurses

Psychiatrists

Psychologists

Social Workers

Mental Health Professions

• Higher Median Ages than other professions, and median ages increasing at a faster rate

• Supply ratios decreasing – and not just supply ratios but actual numbers for some professions

Texas Psychiatrist Facts – 2008

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1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

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1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Psychiatrists:

Total – 1,617




Number of counties with no Psychiatrists – 171


Psychiatrists per 100,000 Population

Psychiatrist: Median Ages

Mental HealthHealth Professional Shortage Areas


As of March 10, 2009 there were 172 whole county Health Profession Shortage Areas (HPSAs) for mental health, and 12 sub-county geographic or special population HPSAs in Texas.

Federally Designated Health Professional Shortage Areas (HPSAs) in Texas for Mental Health

as of March 2009

Designation StatusNot DesignatedSpecial PopulationPartial CountyWhole County

Mental Health Professions - Loss in NumbersLicensed Chemical

Dependency Counselors

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2002 2003 2004 2005 2006 2007 2008

Marriage andFamily Therapists

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PsychiatricNurses

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1996 1998 2000 2002 2004 2006 2008


Mental Health Professions – Median Age Trends

Licensed Professional Counselors

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Licensed Chemical Dependency Counselors

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Marriage and Family Therapists

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Public Health Workforce Surveys

Collected information from:

Local Health Departments

Federally Qualified Health Centers

Health and Human Services Enterprise Agencies:• Department of State Health Services• Department of Aging and Disability Services• Texas Health and Human Services Commission• Department of Family and Protective Services• Department of Aging and Rehabilitative Services

Public Health WorkforceSummary of Surveys

13,063 Currently Staffed FTEs

Largest Professions:

Nursing – 4,173.0Registered Nurses – 2,371.5Licensed Vocational Nurses – 1,801.5

Mental Health Workers – 3,541.0Psychiatric Nursing Aides, Psychiatric Nursing Assistants – 2,775.0Social Workers, licensed and unlicensed – 332.0Psychological Associates – 186.0 Psychiatrists – 132.5Psychologists – 68.5Psychological Assistants – 10.0Other – 37.0

Other Professions:Environmental Health Workers/Engineers/Sanitarians – 650.5Public Health Technicians – 602.5Physicians (not including Psychiatrists) – 523.0Nutritionists and Dietitians – 344.0Dentists – 162.0


Public Health Workforce – Vacancies

2,003.8 Vacant FTEs – 13.3% Vacancy Rate

Professions with the most Vacant FTEs:

Additional FTEs Desired if Budgets Allowed - 857


• Registered Nurses – 692.8• Other Mental Health Workers – 278.5• Licensed Vocational Nurses – 206.9• Public Health Technicians – 170.0• Physicians – 117.8

http://www.dshs.state.tx.us/CHS/hprc/

Demographic Review of theTexas

Health Professions Workforce

Brian King, Program Director, HPRC

Health Professions Resource Center

Center for Health Statistics

Texas Department of State Health Services

Date post:	17-Dec-2015
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Http:// Demographic Review of the Texas Health Professions Workforce Brian King, Program Director,...

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