Doctors and nurses by categories Gaëlle Balestat Meeting of OECD Health Data National Correspondents 3-4 October 2011
Physicians by categories In the JQ, data are collected for 7 categories General practice General paediatrics Obstetrics and gynaecology Psychiatry Medical group of specialties Surgical group of specialties Other categories not elsewhere classified The Eurostat additional module collects more detailed data from European countries 30 categories physicians in training
Mapping between ISCO-08 and the JQ ISCO-08 General practitioners (2211) Specialist practitioners (2212) Medical practitioners, not further defined (2210) Joint Questionnaire - General practice - General paediatrics - Obstetrics and gynaecology - Psychiatry - Medical group of specialties - Surgical group of specialties - Other categories not elsewhere classified (including a few specialties and interns/residents not elsewhere classified)
Progress in 2011 data collection Greater data availability 4 countries have completed the gaps Full table available for 32 countries Greater data consistency Data add up to 100% for most countries Over two thirds of countries provide the data according to the practising concept More detailed S&M
Share of general practitioners, specialists and other doctors, 2009 Source: OECD Health Data 2011.
Per 10 000 population Large variations in general practitioners Source: OECD Health Data 2011.
Explanations for the large variations in general practitioners (and other doctors ) Report of professionally active or licensed physicians, instead of practising physicians Inclusion/exclusion of interns and residents, and their allocation to specific categories or to the Other category Inclusion of non-specialist physicians in General practice or in Other
Proposal for a slightly amended data collection on physicians by categories ISCO-08 Current JQ Possible revision to JQ General practitioners (2211) General practice General practitioners (2211) - Family/General practitioners - Other generalist medical practitioners Specialist practitioners (2212) Medical practitioners, not further defined (2210) General paediatrics Obstetrics & gynaecology Psychiatry Medical group Surgical group Other categories not elsewhere classified Specialist practitioners (2212) - General paediatrics - Obstetrics & gynaecology - Psychiatry - Medical group - Surgical group - Other specialties n.e.c. Other doctors not elsewhere classified
Proposal for a slightly amended data collection on physicians by categories Possible revision to JQ General practitioners (2211) - Family/General practitioners - Other generalist medical practitioners Specialist practitioners (2212) - General paediatrics - Obstetrics & gynaecology - Psychiatry - Medical group - Surgical group - Other specialties n.e.c. Other doctors n.e.c. Including: Physicians responsible for continuous care Interns or residents specialising in general practice Including: Non-specialist physicians in hospital or ambulatory sector Interns or residents without any area of specialisation yet Including interns or residents training for a specialty Including interns or residents not elsewhere classified
Nurses Nurses by categories Professional nurses (ISCO-08 code: 2221) Associate professional nurses (ISCO-08 code: 3221) All 34 OECD countries provided data on nurses, and 30 countries provided the breakdown between professional and associate professional nurses 20 countries also provided data on caring personnel combining health care assistants in institutions (ISCO-08 5321) and home-based personal care workers (ISCO-08 5322)
Nurses and caring personnel per 1000 population, 2009 1. Data refer to all nurses who are licensed to practice. 2. Data include not only nurses providing direct care to patients, but also those working in the health sector as managers, educators, researchers, etc. (adding another 5-10% of nurses). 3. Austria reports only nurses employed in hospitals. 4. Chile includes only nurses working in the public sector. Source: OECD Health Data 2011.
Metadata on the mapping of national categories to international categories (examples) Titles of occupation Tasks Education Professional nurses Registered nurses (Australia, Canada, New Zealand, U.S.) Registered psychiatric nurses (Canada) Advanced practice nurses (e.g. nurse practitioners, etc.) (U.S.) Assess patient health problems and needs, develop and implement nursing care plans, and maintain medical records. Administer nursing care to patients. May advise patients on health maintenance and disease prevention or provide case management. (U.S.) 3-year bachelor or post-graduate degree in nursing (Australia) 3 years of study (Austria, Germany) 4 years of university education leading to a B.Sc degree (Iceland) 3 years or more of study and national examination (Japan) Associate professional nurses Enrolled nurses (Australia, New Zealand) Nursing assistants (New Zealand) Licensed practical nurses (Canada, U.S.) Licensed vocational nurses (U.S.) Care for ill, injured, convalescent or disabled patients. May work under the supervision of a registered nurse. (U.S.) Provide patients with basic nursing care, undertaking less complex procedures than professional nurses (Australia) Vocational education and training course of 1-year duration (Australia) 1 year of study (Austria, Germany) 16 weeks of practical training in health institutions (Iceland) 2 years of study and prefectural examination (Japan)
Discussion Comment on issues/problems faced in allocating doctors and nurses by category when filling the Joint Questionnaire Comment on the proposal to slightly amend the data collection on categories of doctors by: adding a distinction between family doctors/gps and other general/non-specialist doctors; and narrowing the definition of other doctors not elsewhere classified