Caregivers and Quality in Long Term Care

Slide Presentation by Edward Salsberg, Ph.D.

On April 30, 2003, Edward Salsberg, Ph.D., made a presentation in the Web-Assisted Audioconference entitled Caregivers and Quality in Long Term Care.

This is the text version of Dr. Salsberg's slide presentation. Select to access the PowerPoint® slides (194 KB).

Caregivers and Quality in Long Term Care

Edward Salsberg, Ph.D.
Executive Director
Center for Health Workforce Studies
School of Public Health
State University of New York at Albany

Slide 1

Caregivers and Quality in Long Term Care

Edward Salsberg, Ph.D.
Executive Director
Center for Health Workforce Studies
School of Public Health
State University of New York at Albany
http://chws.albany.edu

Slide contains a picture of Edward Salsberg.

Slide 2

The Health Workforce Crisis

• Serious shortages threatening ability to deliver services.
• The squeeze—few new dollars and the high cost of more workers.
• Concerns with medical errors and quality.
• Worker and management dissatisfaction.
• Buried in paperwork and regulation.
• Racial and ethnic imbalances.
• Decreased interest in health careers.
• Lack of systematic data on workforce needs

Slide 3

Factors Contributing to Health Workforce Shortages

Short term factors.

• Educational system response lags.
• Rising demand.
• Increasing case mix complexity.

Long term factors.

• The aging of America: increasing demand and decreasing supply of workers.
• Increasing demand due to increasing income, expanding interventions, and increased survival of individuals with chronic illness.
• Changing racial/ethnic mix.
• Expanded career choices for women.

Slide 4

Factors Contributing to Health Workforce Shortages (continued)

• Workplace factors.
  • Physically and emotionally demanding work.
  • Non-competitive wages and benefits.
  • Job design and working conditions.
  • Paperwork and lack of information systems.
  • Poorly trained managers.

Slide 5

Employment in Health Care Is Expected to Grow Rapidly in Coming Years

• The Bureau of Labor Statistics (BLS) forecasts that employment in all health care occupations will grow by 29 percent between 2000 and 2010, twice as fast as the rest of the economy.
• Total job openings due to growth and replacements between 2000 and 2010 are forecast to be:
  • Registered Nurses: 1,004,000.
  • Nurse Aides, Orderlies, Attendants: 498,000.
  • Home Health Aides: 370,000.
  • Personal and Home Care Aides: 322,000.
  • Licensed Practical Nurses: 322,000.

Source: Bureau of Labor Statistics: Occupational Employment Projections to 2010, Monthly Labor Review, Nov 2001.

Slide 6

Direct Care Workers Comprise the Majority of Workers in Long Term Care

Home Health Care Workforce.

• 50 percent Home health aides and other aides.
• 19 percent RNs.
• 6 percent LPNs.

Nursing Home Workforce.

• 38 percent CNAs and other aides.
• 11 percent LPNs.
• 9 percent RNs.

Slide 7

Long Term Care Aide Shortages: The Worker Perspective

• Low wages and benefits.
  (Certified Nurse Aide: $9.22 per hour; Home Health Aide: $8.38 per hour).
• Alternative jobs.
• Poor working conditions.
• Difficult jobs—physically/mentally demanding.
• Lack of career opportunities: dead end jobs.
• Lack of recognition or status.
• Poor treatment.
• Gap between training and real job demands.

Slide 8

Long Term Care Aide Shortages: The Provider Perspective

• Too little reimbursement.
• State and federal regulations and oversight.
• Poorly prepared workers.
• High turnover.
• Low unemployment rate.
• Increasing patient acuity.
• Growth in total number of jobs.

Slide 9

State Government Roles Related to the Health Workforce

• Licensure and regulation of health professionals.
• Regulation of health facilities.
• Regulation of educational programs.
• State colleges and universities.
• Medicaid reimbursement policies and regulation of private insurance.
• Labor Department training programs and employment data collection.
• Employer in state facilities and agencies.
• Health workforce data collection.

Current as of July 2003

Internet Citation

Caregivers and Quality in Long Term Care. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/workforctel/sess2/salsbergtxt.htm

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