Allied Health Services Avoiding Crises (1989) / Chapter Skim
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3 Forces and Trends in Personnel Demand and Supply
3 Forces and Trends in Personnel Demand and Supply
Pages 63-95
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From page 63... ...
This chapter examines these and other forces to establish a context for Chapter 4, which discusses demand and supply in individual allied health fields. Before considering each of the environmental pressures that projections of employment must take into account, the interaction of several forces in one allied health field—respiratory therapy is illustrated.
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From page 64... ...
Health care financing policies, including pressures to cut health care costs, may fuel the move to home care. On the other hand, financing policies may also be used to curtail an expansion of home care that is made possible by new technologies.
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From page 65... ...
FORCES THAT DRIVE THE DEMAND FOR ALLIED HEALTH PRACTITIONERS Population Growth and Demographic Trends Demographic trends provide clues about tomorrow's health care consumers and their health care needs. An analysis of the changes in the composition and growth of the U.S.
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From page 66... ...
In 1950 there were just 600,000 people aged 85 or older; by the year 2000 it is expected that number will have increased nearly eightfold. As the number of elderly people increases, the demand for allied health practitioners in a variety of fields will rise accordingly.
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From page 67... ...
Children are also major users of disease prevention services, some of which employ allied health practitioners for example, dental hygienists in dental caries prevention. For practitioners in many allied health fields, children represent only a small portion of their practice.
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From page 68... ...
(Public Health Service, Office of Disease Prevention and Health Promotion, 1987~. The expected increase in minority population groups by the year 2000 could have an effect on the need for allied health practitioner services.
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From page 69... ...
The committee noted growing concern about the effect of AIDS on the supply of as well as the demand for allied health practitioners. Some educators fear that potential allied health students may be dissuaded by their .
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From page 70... ...
The demand for allied health practitioners may be influenced both by efforts to curtail the incidence of chronic disease and by medical successes in treating chronic conditions. For example, some allied health fields are directly affected by widespread efforts to reduce the risk factors for cardiovascular disease.
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From page 71... ...
Between the 1986 and year 2000 moderate projections, BLS predicts a 43 percent increase in expenditures. These differences could have an effect on those allied health practitioners whose employment is significantly dependent on Medicare spending.
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From page 72... ...
Structural changes may or may not affect the delivery of health care services and the demand for health care workers. Changes in the location of a service may represent only a change in work site for allied health personnel without altering the number of persons who are actually employed.
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From page 73... ...
The second fastest growing sector offices of health practitionersreflects the growth of such activities as physicians' office labs, office surgery, and independent allied health practices. Nursing homes will also experience rapid growth as the aged population grows and early discharge from hos
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From page 74... ...
The Health Care Financing Administration projects health care expenditures of $1.5 trillion in the year 2000 the major payers being the federal government, which will pay one-third; private insurance, which will pay 30 percent; and patients, who will pay one-quarter (Health Care Financing Administration, 1987~. As health care payers look to the future, the picture is one of increasing costs as the population ages and scientific advances make care ever more complex.
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From page 75... ...
For example, the ability of a hospital to enter the sports medicine market will depend on its ability to attract physical therapists. Second, financing policy also affects the ability of individual allied health practitioners to prosper in the health care market.
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From page 76... ...
In 1986 only 16 percent of labs reported staff increases; a year later, 31 percent were reporting staff increases (Gore, 19871. Another aspect of health care financing mandated benefits may also influence the utilization of health care services.
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From page 77... ...
How technologies that are as yet underdeveloped will influence allied health employment is, of course, not known. Seymour Perry, professor of medicine at Georgetown University and former director of the National Center for Health Care Technology, described the following advances at the workshop held by the committee in April 1987: · Automation in clinical laboratories will progress, decreasing the complexity of tasks and increasing productivity.
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From page 78... ...
The relationship between human resources needs and technological change fluctuates constantly but is seldom explored, making it difficult to assess the future with much certainty. Although we have some understanding of the forces that drive technological change, the effects of such change on allied health practitioners have not been adequately researched.
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From page 79... ...
While in theory the medical doctor license permits the physician to perform most of the tasks of allied health practitioners, in many cases their training has not prepared them to function effectively or productively in the full range of services of many of the allied health fields.
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From page 80... ...
That is not to say that turf issues between allied health practitioners and others will lessen, but it appears that demand for allied health personnel will not be unfavorably affected. FORCES THAT DRIVE THE SUPPLY OF ALLIED HEALTH PRACTITIONERS The discussion thus far has focused on the factors that drive the demand for allied health practitioners.
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From page 81... ...
The labor force is becoming older; it also includes more women and more racial and ethnic minorities than in the past (Table 3-31.* The number of women in the labor force is projected to increase more than twice as fast as the number of men, and in the year 2000 women will constitute nearly half the labor force.
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From page 82... ...
Workers in the allied health fields are primarily women. There are a few fields emergency medical services, for example in which women constitute a small minority; in a few others, such as respiratory therapy, the share of men and women in the work force is roughly equal.
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From page 83... ...
Whereas the increase in men earning associate degrees was only 6 percent, almost 50 percent more women earned associate degrees in 1985 than had earned them a decade earlier. Other degrees awarded for Programs of less than 4 years increased by 45 percent between 1975 1 0 and 1985.
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From page 84... ...
The Center for Education Statistics' 1972, 1977, 1982, and preliminary 1986 data show no trend toward increased college enrollment among people aged 25 to 44. Trends in Women's Choices of Fields of Study The proportion of female baccalaureate graduates who enter health fields (i.e., allied health, health sciences, and nursing)
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From page 85... ...
The BLS expects the number of jobs in some of the fields that are currently popular with women (teaching, psychology, social work, and, surprisingly, most of the business executive occupations) to grow more slowly than the allied health fields in the coming years.
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From page 86... ...
Because the number of female college graduates is projected to remain at close to current levels or to decline only slightly over the next 12 years, the supply of graduates in the allied health fields may remain at close to current levels through the year 2000, despite the decline in the college-age population. Education Financing A commonly cited maxim among allied health leaders relates to the position of allied health in the pecking order of health professions education programs: "Allied health fields are the last to be funded in good times, the first to be cut when resources are reduced." This statement reflects the importance of the economic climate in which higher education resource allocation takes place and how decisions about allied health education resources are related to broader financing trends.
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From page 87... ...
No data are available on aggregate allied health education expenditures, but much of the cost is borne by state and local government expenditures and by tuition support in private institutions. The key driving forces behind allied health education financing are state and local appropriations, student demand, and the availability of clinical facilities and teaching staff.
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From page 88... ...
We noted earlier that the ability of the allied health fields to attract students depends in part on the attractiveness of allied health occupations relative to other occupations open to women. The ease with which a graduate can find work and the earnings that can be expected for that work are both facets of the perceived attractiveness of an occupation.
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From page 89... ...
Unions have not yet become a major factor in many allied health fields, but service workers have become, with some success, the focus of much union activity. The recent swing away from an emphasis on direct economic considerations that nursing unions are exhibiting may provide some clues about the concerns of other health care workers and suggest what may be done to make employment in these fields more attractive.
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From page 90... ...
The supply of allied health practitioners whose autonomy of practice is limited is unlikely to be affected by malpractice considerations. But for some allied health fields, these considerations could, in the future, become an important issue.
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From page 91... ...
First, financing is the major force shaping technology development and adoption, the structure of the industry, and other determinants of allied health personnel demand. Second, health care financing responds, through public and private policy decisions, to other important influences such as the economy, demographics, disease patterns, and social values.
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From page 92... ...
A1though the upward pressures of the aging population would be felt, under this scenario, those pressures would not be sufficient to prevent a small drop in overall hospital utilization. Because hospitalized patients would be more seriously ill, care would be more complex.
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From page 93... ...
Despite uncertainty, however, it is possible to learn more about how these forces influence allied health employment and the supply of workers in allied health fields. Methods may include tracking disease and treatment patterns and how allied health practitioners are used,
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From page 94... ...
Medical Laboratory Observer December:27-30. Health Care Financing Administration.
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From page 95... ...
April 1. Public Health Service, Office of Disease Prevention and Health Promotion.
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