HEALTH LABOUR MARKET TRENDS IN OECD COUNTRIES
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1 HEALTH LABOUR MARKET TRENDS IN OECD COUNTRIES Michael Schoenstein, OECD Health Division 3 rd Global Health Workforce Alliance Forum Recife, 11 November 2013
2 Main health labour market issues in OECD countries since 2008 The crisis had a rapid impact on health workers and policy priorities. Human resource allocation is the most salient topic in OECD countries. A labour productivity agenda will need to address skills mismatch. 2
3 Crisis-related adjustment in the health sector has fallen on wages 10.0% 8.0% 6.0% Hungary GPs Specialists Average wage 8.0% 7.0% 6.0% 5.0% Denmark Doctors (GPs and specialists) Average wage 4.0% 2.0% 4.0% 3.0% 2.0% 0.0% -2.0% % 0.0% -1.0% % -2.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% -1.0% -2.0% France GPs Specialists Average wage % 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% -2.0% Belgium GPs Specialists Average wage
4 Employment held up well: more doctors and nurses than before the crisis USA Japan Doctors Doctors France Italy Doctors Doctors Source: OECD Health Data
5 The increase in HR supply is driven by increasing graduate numbers Number of medical graduates, selected countries, 1990 to 2011 Index (1990=100) 300 Australia Japan Canada United States Index (1990=100) 300 Denmark Netherlands Italy United Kingdom Source: OECD Health Statistics 2013, 5
6 and in many countries by improved retention, e.g. doctors delaying retirement Share of doctors aged 55 or older, OECD countries, 2000 vs or nearest year 2000 Source: OECD Health Data
7 Policy priorities have changed to issues about allocation of human resources No particular issue Maintaining the current level of physician suppply Meeting increasing demand Maintaining the current share of GPs Identified shortage in some specialties Mal-distribution of physician supply Source: OECD Health System Characteristics Survey No particular issue : Netherlands 7
8 All OECD countries consider geographic maldistribution of MDs a key challenge Doctors per inhabitants, TL2 regions, 2011 Source: OECD Regions at a Glance (forthcoming) Australia Austria Belgium Canada Czech Republic Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Israel Italy Japan Korea Luxembourg Mexico Netherlands New Zealand Norway Poland Portugal Slovak Republic Slovenia Spain Sweden Switzerland Turkey United Kingdom United States Lisboa Brussels Vienna Prague Bratislava Physicians density (per population) 8
9 Distribution across specialties is considered inadequate in many countries 60 Share of generalist doctors, selected countries, 1995 to Australia France Germany Netherlands United Kingdom Note: Generalists include general practitioners ( family doctors ) and other generalist (non-specialist) medical practitioners. Source: OECD Health Data
10 Changing team composition is a fastmoving target for many OECD countries Increase in NP/PA, relative to MD, USA, 2000 to NP PA MD Sources: OECD Health Data 2013, US National Commission on Certification of Physician Assistants Certified Physician Assistant Population Trends (PA-Cs), American Association of Colleges of Nursing Annual Surveys 10
11 Task reallocation will require tackling skills mismatch in among current HR 60% Do you feel that you need further training in order to cope well with your present duties? 50% 40% 30% 20% 10% 0% Physicians Other health professionals Others Notes: Preliminary data. Others = other technical and professional occupations (ISCO 2 and 3) Source: PIAAC
12 Main health labour market issues in OECD countries since 2008 The crisis had an immediate impact on health workers and policy priorities. Human resource allocation is the most salient topic in OECD countries. A labour productivity agenda will need to address skills mismatch. 12
13 More information Health at a Glance November Health workforce planning in OECD countries WP 62 The crisis impact on health markets, WP 6x forthcoming in December Geographic imbalances in physician supply and policy responses, WP 6x forthcoming in December 13
14 HEALTH LABOUR MARKET TRENDS IN OECD COUNTRIES Michael Schoenstein, OECD Health Division 3 rd Global Health Workforce Alliance Forum Recife, 11 November 2013
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