VI.
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Appendix:
State-Level Supply, Demand, and Shortage
Projections
Exhibit
A-1. Baseline FTE RN Supply, by State
and Year, 2000 to 2020
STATE |
SSRN
Estimate |
Projection |
Change
from
2000–2020 |
2000 |
2005 |
2010 |
2015 |
2020 |
AK |
4,200 |
3,800 |
3,200 |
2,500 |
2,000 |
-52% |
AL |
29,900 |
33,700 |
36,600 |
38,200 |
39,100 |
31% |
AR |
16,400 |
18,100 |
19,300 |
19,800 |
19,900 |
21% |
AZ |
29,000 |
30,100 |
30,700 |
30,500 |
30,100 |
4% |
CA |
155,500 |
156,200 |
153,300 |
148,200 |
144,300 |
-7% |
CO |
28,100 |
28,300 |
27,200 |
25,100 |
23,000 |
-18% |
CT |
28,000 |
25,400 |
22,900 |
19,900 |
17,200 |
-39% |
DC |
7,300 |
6,900 |
6,500 |
5,900 |
5,400 |
-26% |
DE |
6,100 |
6,300 |
6,300 |
6,100 |
5,800 |
-5% |
FL |
108,100 |
111,100 |
112,000 |
110,200 |
106,600 |
-1% |
GA |
49,400 |
49,500 |
48,200 |
45,300 |
41,800 |
-15% |
HI |
7,200 |
7,700 |
7,900 |
8,100 |
8,200 |
14% |
IA |
25,200 |
26,300 |
26,600 |
26,000 |
25,000 |
-1% |
ID |
7,000 |
7,300 |
7,400 |
7,300 |
7,100 |
1% |
IL |
88,100 |
88,000 |
85,600 |
81,900 |
77,100 |
-12% |
IN |
41,400 |
41,800 |
41,600 |
40,400 |
38,500 |
-7% |
KS |
20,600 |
21,600 |
22,100 |
21,800 |
21,100 |
2% |
KY |
28,800 |
32,300 |
34,700 |
35,500 |
35,300 |
23% |
LA |
30,200 |
34,100 |
37,200 |
39,100 |
39,800 |
32% |
MA |
63,600 |
62,700 |
60,100 |
56,000 |
51,400 |
-19% |
MD |
36,400 |
36,500 |
35,600 |
33,800 |
31,800 |
-13% |
ME |
11,200 |
11,600 |
11,600 |
11,100 |
10,500 |
-6% |
MI |
70,000 |
72,400 |
72,000 |
68,900 |
66,000 |
-6% |
MN |
39,200 |
41,000 |
41,800 |
41,200 |
39,700 |
1% |
MO |
44,400 |
45,600 |
45,700 |
44,200 |
42,800 |
-4% |
MS |
18,400 |
20,900 |
22,600 |
23,600 |
23,800 |
29% |
MT |
6,400 |
6,500 |
6,500 |
6,300 |
5,900 |
-8% |
NC |
59,900 |
64,500 |
67,400 |
68,600 |
68,000 |
14% |
ND |
5,400 |
5,700 |
5,800 |
5,800 |
5,600 |
4% |
NE |
13,300 |
14,100 |
14,700 |
14,900 |
14,900 |
12% |
NH |
9,300 |
9,500 |
9,300 |
8,800 |
8,100 |
-13% |
NJ |
60,400 |
58,200 |
55,000 |
50,500 |
44,900 |
-26% |
NM |
9,600 |
10,500 |
11,000 |
11,300 |
11,500 |
20% |
NV |
9,000 |
9,300 |
9,200 |
8,700 |
8,100 |
-10% |
NY |
138,100 |
142,600 |
142,300 |
137,400 |
131,500 |
-5% |
OH |
86,900 |
89,300 |
88,900 |
85,500 |
79,700 |
-8% |
OK |
18,900 |
20,600 |
21,500 |
22,100 |
22,500 |
19% |
OR |
21,800 |
22,600 |
22,400 |
21,100 |
19,800 |
-9% |
PA |
111,800 |
105,900 |
99,200 |
90,600 |
80,400 |
-28% |
RI |
9,300 |
9,300 |
9,000 |
8,400 |
7,900 |
-15% |
SC |
23,400 |
25,100 |
25,900 |
26,200 |
26,000 |
11% |
SD |
7,000 |
7,600 |
7,900 |
7,900 |
7,800 |
11% |
TN |
40,900 |
42,700 |
42,800 |
41,800 |
40,100 |
-2% |
TX |
107,600 |
115,300 |
118,700 |
119,000 |
118,500 |
10% |
UT |
11,400 |
12,900 |
14,100 |
14,900 |
15,400 |
35% |
VA |
46,300 |
47,600 |
47,600 |
46,300 |
44,000 |
-5% |
VT |
4,900 |
5,000 |
4,800 |
4,400 |
4,000 |
-18% |
WA |
37,900 |
38,100 |
37,300 |
35,100 |
33,000 |
-13% |
WI |
41,300 |
42,900 |
43,300 |
42,200 |
40,100 |
-3% |
WV |
13,200 |
14,200 |
14,600 |
14,600 |
14,000 |
6% |
WY |
3,200 |
3,300 |
3,300 |
3,300 |
3,300 |
3% |
U.S.
a |
1,890,700 |
1,942,500 |
1,941,200 |
1,886,100 |
1,808,000 |
-4% |
a
Due to rounding, national totals might
fail to equal the sum across states.
Exhibit
A-2. Baseline FTE RN Demand, by State
and Year, 2000 to 2020
State |
SSRN
Estimate |
Projection |
Change
from 2000–2020 |
1996 |
2000 |
2005 |
2010 |
2015 |
2020 |
AK |
4,400 |
4,300 |
4,900 |
5,500 |
6,100 |
6,700 |
56% |
AL |
30,900 |
31,400 |
33,900 |
36,800 |
40,300 |
44,400 |
41% |
AR |
16,100 |
18,500 |
20,200 |
22,000 |
24,300 |
26,900 |
45% |
AZ |
28,900 |
34,000 |
38,700 |
43,200 |
48,500 |
54,700 |
61% |
CA |
159,500 |
165,500 |
178,700 |
200,900 |
228,900 |
260,900 |
58% |
CO |
27,500 |
30,000 |
34,000 |
38,100 |
42,500 |
47,500 |
58% |
CT |
28,200 |
30,200 |
31,800 |
34,000 |
36,600 |
39,600 |
31% |
DC |
8,500 |
8,800 |
8,900 |
9,500 |
10,200 |
11,000 |
25% |
DE |
5,800 |
6,400 |
7,000 |
7,600 |
8,100 |
8,800 |
38% |
FL |
107,300 |
115,500 |
129,300 |
144,700 |
164,300 |
187,800 |
63% |
GA |
48,700 |
52,800 |
58,400 |
64,600 |
71,600 |
79,500 |
51% |
HI |
8,200 |
10,000 |
11,100 |
12,400 |
13,900 |
15,700 |
57% |
IA |
24,400 |
27,100 |
28,600 |
30,000 |
31,800 |
34,100 |
26% |
ID |
6,000 |
6,200 |
7,300 |
8,200 |
9,200 |
10,500 |
69% |
IL |
88,400 |
85,200 |
89,600 |
94,900 |
101,300 |
109,000 |
28% |
IN |
40,800 |
43,000 |
46,600 |
49,800 |
53,500 |
57,400 |
33% |
KS |
19,000 |
20,200 |
21,500 |
23,100 |
24,900 |
27,000 |
34% |
KY |
26,900 |
29,200 |
31,200 |
33,500 |
36,300 |
39,400 |
35% |
LA |
30,700 |
31,800 |
34,200 |
37,100 |
40,600 |
44,600 |
40% |
MA |
59,900 |
68,300 |
71,700 |
76,200 |
81,700 |
87,800 |
29% |
MD |
38,300 |
36,800 |
39,400 |
42,600 |
46,100 |
50,000 |
36% |
ME |
11,400 |
12,400 |
13,100 |
14,100 |
15,300 |
16,800 |
35% |
MI |
69,100 |
67,700 |
71,300 |
75,100 |
79,600 |
84,300 |
25% |
MN |
35,400 |
39,200 |
42,600 |
46,200 |
50,400 |
55,300 |
41% |
MO |
45,000 |
51,600 |
54,900 |
58,600 |
63,100 |
68,200 |
32% |
MS |
18,700 |
19,900 |
21,400 |
23,100 |
25,400 |
28,000 |
41% |
MT |
5,800 |
5,500 |
6,300 |
7,000 |
7,800 |
8,800 |
60% |
NC |
54,400 |
61,500 |
68,400 |
75,500 |
83,700 |
92,900 |
51% |
ND |
5,900 |
5,800 |
6,200 |
6,700 |
7,300 |
8,000 |
38% |
NE |
13,400 |
14,800 |
15,900 |
17,100 |
18,500 |
20,200 |
36% |
NH |
9,800 |
10,500 |
11,500 |
12,600 |
13,800 |
15,100 |
44% |
NJ |
59,700 |
65,600 |
69,700 |
74,600 |
80,400 |
87,300 |
33% |
NM |
10,200 |
11,000 |
12,500 |
14,100 |
15,900 |
18,000 |
64% |
NV |
8,800 |
10,200 |
12,100 |
13,300 |
14,700 |
16,200 |
59% |
NY |
148,100 |
151,000 |
156,000 |
163,800 |
174,000 |
185,700 |
23% |
OH |
86,400 |
90,500 |
95,700 |
101,000 |
107,300 |
113,700 |
26% |
OK |
18,400 |
18,400 |
20,000 |
22,000 |
24,300 |
27,000 |
47% |
OR |
21,100 |
22,000 |
24,800 |
27,700 |
31,100 |
35,100 |
60% |
PA |
107,100 |
110,200 |
115,000 |
120,300 |
127,200 |
135,200 |
23% |
RI |
9,300 |
10,900 |
11,400 |
12,000 |
12,800 |
13,800 |
27% |
SC |
24,200 |
25,700 |
28,300 |
31,100 |
34,400 |
38,100 |
48% |
SD |
7,000 |
6,900 |
7,500 |
8,100 |
8,700 |
9,500 |
38% |
TN |
43,100 |
50,600 |
55,800 |
61,300 |
67,800 |
75,400 |
49% |
TX |
117,000 |
129,100 |
143,800 |
160,600 |
179,900 |
202,100 |
57% |
UT |
11,000 |
12,000 |
13,800 |
15,600 |
17,500 |
19,600 |
63% |
VA |
47,800 |
49,200 |
53,600 |
58,600 |
64,300 |
70,300 |
43% |
VT |
4,300 |
4,600 |
5,000 |
5,400 |
5,800 |
6,300 |
37% |
WA |
34,400 |
36,300 |
40,800 |
46,100 |
52,100 |
59,100 |
63% |
WI |
37,200 |
37,000 |
39,800 |
42,800 |
46,300 |
50,300 |
36% |
WV |
13,500 |
12,600 |
13,200 |
13,900 |
14,700 |
15,700 |
25% |
WY |
3,500 |
3,500 |
4,000 |
4,500 |
5,100 |
5,800 |
66% |
U.S.a |
1,889,300 |
2,001,500 |
2,161,300 |
2,347,000 |
2,569,800 |
2,824,900 |
41% |
a
Due to rounding, national totals might
fail to equal the sum across states.
Exhibit
A-3. Baseline FTE RN Supply and Demand,
2000 and 2005
State |
2000 |
2005 |
Supply |
Demand |
Supply
- Demand |
Supply
÷ Demand |
Supply |
Demand |
Supply
- Demand |
Supply
÷ Demand |
AK |
4,200 |
4,300 |
-100 |
98% |
3,800 |
4,900 |
-1,100 |
78% |
AL |
29,900 |
31,400 |
-1,500 |
95% |
33,700 |
33,900 |
-200 |
99% |
AR |
16,400 |
18,500 |
-2,100 |
89% |
18,100 |
20,200 |
-2,100 |
90% |
AZ |
29,000 |
34,000 |
-5,000 |
85% |
30,100 |
38,700 |
-8,600 |
78% |
CA |
155,500 |
165,500 |
-10,000 |
94% |
156,200 |
178,700 |
-22,500 |
87% |
CO |
28,100 |
30,000 |
-1,900 |
94% |
28,300 |
34,000 |
-5,700 |
83% |
CT |
28,000 |
30,200 |
-2,200 |
93% |
25,400 |
31,800 |
-6,400 |
80% |
DC |
7,300 |
8,800 |
-1,500 |
83% |
6,900 |
8,900 |
-2,000 |
78% |
DE |
6,100 |
6,400 |
-300 |
95% |
6,300 |
7,000 |
-700 |
90% |
FL |
108,100 |
115,500 |
-7,400 |
94% |
111,100 |
129,300 |
-18,200 |
86% |
GA |
49,400 |
52,800 |
-3,400 |
94% |
49,500 |
58,400 |
-8,900 |
85% |
HI |
7,200 |
10,000 |
-2,800 |
72% |
7,700 |
11,100 |
-3,400 |
69% |
IA |
25,200 |
27,100 |
-1,900 |
93% |
26,300 |
28,600 |
-2,300 |
92% |
ID |
7,000 |
6,200 |
800 |
113% |
7,300 |
7,300 |
0 |
100% |
IL |
88,100 |
85,200 |
2,900 |
103% |
88,000 |
89,600 |
-1,600 |
98% |
IN |
41,400 |
43,000 |
-1,600 |
96% |
41,800 |
46,600 |
-4,800 |
90% |
KS |
20,600 |
20,200 |
400 |
102% |
21,600 |
21,500 |
100 |
100% |
KY |
28,800 |
29,200 |
-400 |
99% |
32,300 |
31,200 |
1,100 |
104% |
LA |
30,200 |
31,800 |
-1,600 |
95% |
34,100 |
34,200 |
-100 |
100% |
MA |
63,600 |
68,300 |
-4,700 |
93% |
62,700 |
71,700 |
-9,000 |
87% |
MD |
36,400 |
36,800 |
-400 |
99% |
36,500 |
39,400 |
-2,900 |
93% |
ME |
11,200 |
12,400 |
-1,200 |
90% |
11,600 |
13,100 |
-1,500 |
89% |
MI |
70,000 |
67,700 |
2,300 |
103% |
72,400 |
71,300 |
1,100 |
102% |
MN |
39,200 |
39,200 |
0 |
100% |
41,000 |
42,600 |
-1,600 |
96% |
MO |
44,400 |
51,600 |
-7,200 |
86% |
45,600 |
54,900 |
-9,300 |
83% |
MS |
18,400 |
19,900 |
-1,500 |
92% |
20,900 |
21,400 |
-500 |
98% |
MT |
6,400 |
5,500 |
900 |
116% |
6,500 |
6,300 |
200 |
103% |
NC |
59,900 |
61,500 |
-1,600 |
97% |
64,500 |
68,400 |
-3,900 |
94% |
ND |
5,400 |
5,800 |
-400 |
93% |
5,700 |
6,200 |
-500 |
92% |
NE |
13,300 |
14,800 |
-1,500 |
90% |
14,100 |
15,900 |
-1,800 |
89% |
NH |
9,300 |
10,500 |
-1,200 |
89% |
9,500 |
11,500 |
-2,000 |
83% |
NJ |
60,400 |
65,600 |
-5,200 |
92% |
58,200 |
69,700 |
-11,500 |
84% |
NM |
9,600 |
11,000 |
-1,400 |
87% |
10,500 |
12,500 |
-2,000 |
84% |
NV |
9,000 |
10,200 |
-1,200 |
88% |
9,300 |
12,100 |
-2,800 |
77% |
NY |
138,100 |
151,000 |
-12,900 |
91% |
142,600 |
156,000 |
-13,400 |
91% |
OH |
86,900 |
90,500 |
-3,600 |
96% |
89,300 |
95,700 |
-6,400 |
93% |
OK |
18,900 |
18,400 |
500 |
103% |
20,600 |
20,000 |
600 |
103% |
OR |
21,800 |
22,000 |
-200 |
99% |
22,600 |
24,800 |
-2,200 |
91% |
PA |
111,800 |
110,200 |
1,600 |
101% |
105,900 |
115,000 |
-9,100 |
92% |
RI |
9,300 |
10,900 |
-1,600 |
85% |
9,300 |
11,400 |
-2,100 |
82% |
SC |
23,400 |
25,700 |
-2,300 |
91% |
25,100 |
28,300 |
-3,200 |
89% |
SD |
7,000 |
6,900 |
100 |
101% |
7,600 |
7,500 |
100 |
101% |
TN |
40,900 |
50,600 |
-9,700 |
81% |
42,700 |
55,800 |
-13,100 |
77% |
TX |
107,600 |
129,100 |
-21,500 |
83% |
115,300 |
143,800 |
-28,500 |
80% |
UT |
11,400 |
12,000 |
-600 |
95% |
12,900 |
13,800 |
-900 |
93% |
VA |
46,300 |
49,200 |
-2,900 |
94% |
47,600 |
53,600 |
-6,000 |
89% |
VT |
4,900 |
4,600 |
300 |
107% |
5,000 |
5,000 |
0 |
100% |
WA |
37,900 |
36,300 |
1,600 |
104% |
38,100 |
40,800 |
-2,700 |
93% |
WI |
41,300 |
37,000 |
4,300 |
112% |
42,900 |
39,800 |
3,100 |
108% |
WV |
13,200 |
12,600 |
600 |
105% |
14,200 |
13,200 |
1,000 |
108% |
WY |
3,200 |
3,500 |
-300 |
91% |
3,300 |
4,000 |
-700 |
83% |
U.S.a |
1,890,700 |
2,001,500 |
-110,800 |
94% |
1,942,500 |
2,161,300 |
-218,800 |
90% |
a
Due to rounding, national totals might
fail to equal the sum across states.
Exhibit
A-4. Baseline FTE RN Supply and Demand,
2010 and 2015
State |
2010 |
2015 |
Supply |
Demand |
Supply
- Demand |
Supply
÷ Demand |
Supply |
Demand |
Supply
- Demand |
Supply
÷
Demand |
AK |
3,200 |
5,500 |
-2,300 |
58% |
2,500 |
6,100 |
-3,600 |
41% |
AL |
36,600 |
36,800 |
-200 |
99% |
38,200 |
40,300 |
-2,100 |
95% |
AR |
19,300 |
22,000 |
-2,700 |
88% |
19,800 |
24,300 |
-4,500 |
81% |
AZ |
30,700 |
43,200 |
-12,500 |
71% |
30,500 |
48,500 |
-18,000 |
63% |
CA |
153,300 |
200,900 |
-47,600 |
76% |
148,200 |
228,900 |
-80,700 |
65% |
CO |
27,200 |
38,100 |
-10,900 |
71% |
25,100 |
42,500 |
-17,400 |
59% |
CT |
22,900 |
34,000 |
-11,100 |
67% |
19,900 |
36,600 |
-16,700 |
54% |
DC |
6,500 |
9,500 |
-3,000 |
68% |
5,900 |
10,200 |
-4,300 |
58% |
DE |
6,300 |
7,600 |
-1,300 |
83% |
6,100 |
8,100 |
-2,000 |
75% |
FL |
112,000 |
144,700 |
-32,700 |
77% |
110,200 |
164,300 |
-54,100 |
67% |
GA |
48,200 |
64,600 |
-16,400 |
75% |
45,300 |
71,600 |
-26,300 |
63% |
HI |
7,900 |
12,400 |
-4,500 |
64% |
8,100 |
13,900 |
-5,800 |
58% |
IA |
26,600 |
30,000 |
-3,400 |
89% |
26,000 |
31,800 |
-5,800 |
82% |
ID |
7,400 |
8,200 |
-800 |
90% |
7,300 |
9,200 |
-1,900 |
79% |
IL |
85,600 |
94,900 |
-9,300 |
90% |
81,900 |
101,300 |
-19,400 |
81% |
IN |
41,600 |
49,800 |
-8,200 |
84% |
40,400 |
53,500 |
-13,100 |
76% |
KS |
22,100 |
23,100 |
-1,000 |
96% |
21,800 |
24,900 |
-3,100 |
88% |
KY |
34,700 |
33,500 |
1,200 |
104% |
35,500 |
36,300 |
-800 |
98% |
LA |
37,200 |
37,100 |
100 |
100% |
39,100 |
40,600 |
-1,500 |
96% |
MA |
60,100 |
76,200 |
-16,100 |
79% |
56,000 |
81,700 |
-25,700 |
69% |
MD |
35,600 |
42,600 |
-7,000 |
84% |
33,800 |
46,100 |
-12,300 |
73% |
ME |
11,600 |
14,100 |
-2,500 |
82% |
11,100 |
15,300 |
-4,200 |
73% |
MI |
72,000 |
75,100 |
-3,100 |
96% |
68,900 |
79,600 |
-10,700 |
87% |
MN |
41,800 |
46,200 |
-4,400 |
90% |
41,200 |
50,400 |
-9,200 |
82% |
MO |
45,700 |
58,600 |
-12,900 |
78% |
44,200 |
63,100 |
-18,900 |
70% |
MS |
22,600 |
23,100 |
-500 |
98% |
23,600 |
25,400 |
-1,800 |
93% |
MT |
6,500 |
7,000 |
-500 |
93% |
6,300 |
7,800 |
-1,500 |
81% |
NC |
67,400 |
75,500 |
-8,100 |
89% |
68,600 |
83,700 |
-15,100 |
82% |
ND |
5,800 |
6,700 |
-900 |
87% |
5,800 |
7,300 |
-1,500 |
79% |
NE |
14,700 |
17,100 |
-2,400 |
86% |
14,900 |
18,500 |
-3,600 |
81% |
NH |
9,300 |
12,600 |
-3,300 |
74% |
8,800 |
13,800 |
-5,000 |
64% |
NJ |
55,000 |
74,600 |
-19,600 |
74% |
50,500 |
80,400 |
-29,900 |
63% |
NM |
11,000 |
14,100 |
-3,100 |
78% |
11,300 |
15,900 |
-4,600 |
71% |
NV |
9,200 |
13,300 |
-4,100 |
69% |
8,700 |
14,700 |
-6,000 |
59% |
NY |
142,300 |
163,800 |
-21,500 |
87% |
137,400 |
174,000 |
-36,600 |
79% |
OH |
88,900 |
101,000 |
-12,100 |
88% |
85,500 |
107,300 |
-21,800 |
80% |
OK |
21,500 |
22,000 |
-500 |
98% |
22,100 |
24,300 |
-2,200 |
91% |
OR |
22,400 |
27,700 |
-5,300 |
81% |
21,100 |
31,100 |
-10,000 |
68% |
PA |
99,200 |
120,300 |
-21,100 |
82% |
90,600 |
127,200 |
-36,600 |
71% |
RI |
9,000 |
12,000 |
-3,000 |
75% |
8,400 |
12,800 |
-4,400 |
66% |
SC |
25,900 |
31,100 |
-5,200 |
83% |
26,200 |
34,400 |
-8,200 |
76% |
SD |
7,900 |
8,100 |
-200 |
98% |
7,900 |
8,700 |
-800 |
91% |
TN |
42,800 |
61,300 |
-18,500 |
70% |
41,800 |
67,800 |
-26,000 |
62% |
TX |
118,700 |
160,600 |
-41,900 |
74% |
119,000 |
179,900 |
-60,900 |
66% |
UT |
14,100 |
15,600 |
-1,500 |
90% |
14,900 |
17,500 |
-2,600 |
85% |
VA |
47,600 |
58,600 |
-11,000 |
81% |
46,300 |
64,300 |
-18,000 |
72% |
VT |
4,800 |
5,400 |
-600 |
89% |
4,400 |
5,800 |
-1,400 |
76% |
WA |
37,300 |
46,100 |
-8,800 |
81% |
35,100 |
52,100 |
-17,000 |
67% |
WI |
43,300 |
42,800 |
500 |
101% |
42,200 |
46,300 |
-4,100 |
91% |
WV |
14,600 |
13,900 |
700 |
105% |
14,600 |
14,700 |
-100 |
99% |
WY |
3,300 |
4,500 |
-1,200 |
73% |
3,300 |
5,100 |
-1,800 |
65% |
U.S.a |
1,941,200 |
2,347,000 |
-405,800 |
83% |
1,886,100 |
2,569,800 |
-683,700 |
73% |
a
Due to rounding, national totals might
fail to equal the sum across states.
Exhibit
A-5. Baseline FTE RN Supply and Demand,
2020
State |
2020 |
Supply |
Demand |
Supply
- Demand |
Supply
÷ Demand |
AK |
2,000 |
6,700 |
-4,700 |
30% |
AL |
39,100 |
44,400 |
-5,300 |
88% |
AR |
19,900 |
26,900 |
-7,000 |
74% |
AZ |
30,100 |
54,700 |
-24,600 |
55% |
CA |
144,300 |
260,900 |
-116,600 |
55% |
CO |
23,000 |
47,500 |
-24,500 |
48% |
CT |
17,200 |
39,600 |
-22,400 |
43% |
DC |
5,400 |
11,000 |
-5,600 |
49% |
DE |
5,800 |
8,800 |
-3,000 |
66% |
FL |
106,600 |
187,800 |
-81,200 |
57% |
GA |
41,800 |
79,500 |
-37,700 |
53% |
HI |
8,200 |
15,700 |
-7,500 |
52% |
IA |
25,000 |
34,100 |
-9,100 |
73% |
ID |
7,100 |
10,500 |
-3,400 |
68% |
IL |
77,100 |
109,000 |
-31,900 |
71% |
IN |
38,500 |
57,400 |
-18,900 |
67% |
KS |
21,100 |
27,000 |
-5,900 |
78% |
KY |
35,300 |
39,400 |
-4,100 |
90% |
LA |
39,800 |
44,600 |
-4,800 |
89% |
MA |
51,400 |
87,800 |
-36,400 |
59% |
MD |
31,800 |
50,000 |
-18,200 |
64% |
ME |
10,500 |
16,800 |
-6,300 |
63% |
MI |
66,000 |
84,300 |
-18,300 |
78% |
MN |
39,700 |
55,300 |
-15,600 |
72% |
MO |
42,800 |
68,200 |
-25,400 |
63% |
MS |
23,800 |
28,000 |
-4,200 |
85% |
MT |
5,900 |
8,800 |
-2,900 |
67% |
NC |
68,000 |
92,900 |
-24,900 |
73% |
ND |
5,600 |
8,000 |
-2,400 |
70% |
NE |
14,900 |
20,200 |
-5,300 |
74% |
NH |
8,100 |
15,100 |
-7,000 |
54% |
NJ |
44,900 |
87,300 |
-42,400 |
51% |
NM |
11,500 |
18,000 |
-6,500 |
64% |
NV |
8,100 |
16,200 |
-8,100 |
50% |
NY |
131,500 |
185,700 |
-54,200 |
71% |
OH |
79,700 |
113,700 |
-34,000 |
70% |
OK |
22,500 |
27,000 |
-4,500 |
83% |
OR |
19,800 |
35,100 |
-15,300 |
56% |
PA |
80,400 |
135,200 |
-54,800 |
59% |
RI |
7,900 |
13,800 |
-5,900 |
57% |
SC |
26,000 |
38,100 |
-12,100 |
68% |
SD |
7,800 |
9,500 |
-1,700 |
82% |
TN |
40,100 |
75,400 |
-35,300 |
53% |
TX |
118,500 |
202,100 |
-83,600 |
59% |
UT |
15,400 |
19,600 |
-4,200 |
79% |
VA |
44,000 |
70,300 |
-26,300 |
63% |
VT |
4,000 |
6,300 |
-2,300 |
63% |
WA |
33,000 |
59,100 |
-26,100 |
56% |
WI |
40,100 |
50,300 |
-10,200 |
80% |
WV |
14,000 |
15,700 |
-1,700 |
89% |
WY |
3,300 |
5,800 |
-2,500 |
57% |
U.S.a |
1,808,000 |
2,824,900 |
-1,016,900 |
64% |
a
Due to rounding, national totals might
fail to equal the sum across states.
[1]
The modeling and resulting projections
used in this paper were developed under
contract DHHS-250-01-0001 with the Lewin
Group. Tim Dall, Lewin Group, was the
principal investigator for the contract.
This paper was prepared in a joint effort
by Marilyn B. Biviano, Steve Tise, Marshall
Fritz and William Spencer. Additional
information on these models,
projections from these models, and the
data and assumptions are available in
other reports: Projected Supply, Demand,
and Shortages of Registered Nurses:2000–2020
(BHPr, 2002),
NSM: Technical Report and User Guide (BHPr,
2004), NDM: Development and Baseline Projections
(BHPr, 2004), and NDM User Guide (BHPr,
2004).
[2]
The U.S. Census Bureau’s projections were
developed before the 2000 Census and underestimated
the U.S. population in 2000. Consequently,
we adjusted the projections to reflect
this undercount. Men continue to constitute
a small percentage of the RN workforce,
doubling from approximately 2.7% in 1980
to 5.4% in 2000 (BHPr, 2001). As the proportion
of RNs who are male grows, the NSM might
have to add a gender component to track
difference in workforce participation
patterns and retirement rates between
male and female RNs.
[3]
The data, methods, and assumptions used
to calculate baseline demand projections
are described in Section III .
[4]
An annual survey of RN salaries finds
that RN hourly earnings increased by nearly
7%, on average, between 2002 and 2003
(Robinson and Mee, 2003).
[5] NDM Development
and Baseline Projections (NCHWA, forthcoming),
NDM User’s Guide (NCHWA, forthcoming),
and The Nursing Demand–Based Requirements
Forecasting Model (Fritz, 1999).
[6] To estimate per capita
use of healthcare services, we use the
1996 Health Cost Utilization Project (HCUP)
database for hospital inpatient services,
1996 National Hospital Ambulatory Care
Survey (NHAMCS) for hospital outpatient
and emergency services, 1997 National
Nursing Home Survey (NNHS) for nursing
facilities, and 1995 National Home and
Hospice Care Survey (NHHCS) for home health.
See Section 0 for a discussion of the
choice of 1996 as the base year.
[7]
Estimates of actual use of healthcare
services come from multiple sources. The
American Hospital Association (AHA) provides
state-level estimates of inpatient days,
outpatient visits, and emergency visits.
The American Health Care Association (AHCA)
provides state-level estimates of residents
in nursing facilities. State-level estimates
of home health visits were constructed
using data from the Centers for Medicaid
and Medicare Services (CMS) and other
sources.
[8] Preliminary analyses
to control for heteroskedasticity included
the estimation of “difference-in-differences”
models, using regression analysis, to
control for state fixed effects. In these
regressions, both the dependent and exogenous
variables are transformed so the estimate
for each state in a particular year is
that year’s deviation from the state’s
multiyear average. One important limitation
of the difference-in-differences approach
is that it eliminates cross-state variation
in the dependent and exogenous variables,
which is an important source of information
for estimating the relationship between
healthcare use and its determinants. For
example, HMO enrollment rates vary substantially
across states, but in a given state might
change little over the few years included
in the regression analysis. Many of the
exogenous variables that were statistically
significant in the difference-in-differences
models are the same variables used in
the NDM’s final projection equations.
[9]
The HMO variable (and assessment trend)
is included as a proxy for factors that
make clinicians and consumers more cost-conscious,
whether that be through the application
of managed care principles or out-of-pocket
costs such as co-pay and deductibles.
[10] The ability of
healthcare providers to substitute lower-cost
nurses for higher-cost nurses is more
than simply an economic phenomenon; rather,
it also reflects legal and quality considerations.
RNs receive special training that enables
them to provide certain services that
LPNs cannot provide. Thus, in only a limited
range could substitution be made without
jeopardizing healthcare delivery quality.
[11] Lane and Gohmann
estimate nurse supply and demand simultaneously
using two approaches: (1) a two-stage
least squares model and (2) a “switching”
model that relaxes the assumption that
the market for hospital nurses is in equilibrium.
The authors report an own-wage elasticity
of demand of -1.14 when using the two-stage
least squares model, but they believe
the estimate of -0.92 from the switching
model to be more accurate. |