Download Dental Workforce Data Presentation

MAINE HEALTH WORKFORCE SUMMIT
Understanding the Dental
Workforce:
What Does The Data Tell Us
About Maine’s Needs?
October 18, 2011
Judith A. Feinstein, MSPH
Director, Oral Health Program
Maine CDC
1
OBJECTIVES
 Provide
an overview of Maine’s dental
workforce and describe the data sources
 Discuss the conclusions can be drawn and
what questions are raised by the data
 Review how workforce data can be used to
inform strategies for addressing Maine’s
dental workforce development needs
 Discuss how to address Maine’s data needs
 Examine recommended actions/steps that
are being or could/should be taken by all
interested parties
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CAVEATS
Remember…
 “Without data, you are just an
opinion.”
 “You can’t fix with statistics what you
bungled by design.” -- and - “If you torture the data long enough, it
will confess.”
– OR –
The answer you get depends
on the question you ask

Source of quotes: unnamed but not to be forgotten CDC evaluators
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FEDERALLY DESIGNATED DENTAL HEALTH
PROFESSIONAL SHORTAGE AREAS - 2011
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DENTIST TO POPULATION RATIO
ME Dept of Labor, Workforce Analysis of Maine’s
Health Services Sector, issued April 2010
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DENTAL HYGIENISTS –
POPULATION RATIO
ME Dept of Labor, Workforce Analysis of Maine’s
Health Services Sector, issued April 2010
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NEED FOR MORE
PRACTITIONERS?
ME Dept of Labor, Workforce Analysis of Maine’s
Health Services Sector, issued April 2010
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A CLOSER LOOK AT THE
DATA ...
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… and the questions we ask to get it
DATA SOURCES



Licensure data – Maine Board of Dental
Examiners
Maine Cooperative Health Manpower
Resource Inventory surveys
 Dentist Resource Inventory
 Registered Dental Hygienist Resource
Inventory
National Sources, e.g., HRSA
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DATA AND ITS LIMITATIONS
Issues - Survey construction and
administration (methods)
 Voluntary or mandatory
 Questions (wording)
 Response rates
 Interpretations
 Statistical analyses
 Biases
Numerator
Denominator
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NUMBER OF LICENSED DENTISTS AND
HYGIENISTS AS REPORTED BY THE STATE BOARD
OF DENTAL EXAMINERS *
Year
Dentists
Licensed
(Inactive)
Maine
Address
2011
835 (7)
665 (3)
2010
800 (8)
653 (3)
2009
833 (8)
671 (2)
2008
818
2007
2006
Hygienists
Licensed
(Inactive)
Maine
Address
1290
(36)
1341
(50)
1301
(54)
1194
(36)
1179
(36)
1175
(34)
662
1238
1130
831
648
1335
1146
n/a
604
n/a
1082
IPDHs
Licensed
Maine
Address
33
31
18
16
11
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* Point in time data: Numbers obtained annually in January or February
in response to a query from the ME Oral Health Program to answer a
survey – not an official report.
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY –
DENTISTS, 2008





Most dentists practicing in Maine
are white males over the age of 50.
The typical dentist in Maine has been practicing
for 24.4 years. Only 15% of those surveyed have
been working for 10 years or less.
As dentists get older, they cut back on hours and
are more likely to work part-time.
Female dentists work fewer hours and weeks/year
than male dentists.
There is no statistically significant difference in
hours between dentists working in urban and
rural settings.
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – DENTISTS, 2008




If reaching age 65 was the only determinant of
retirement-related turnover, 25% of dentists
currently working will retire within 5 years, 44%
within 10 years and 62% within 15 years.
If rural areas are not able to recruit younger
dentists the gap between retirement-related
turnover in rural and urban areas becomes more
severe as time passes.
Intent to leave within 5 years is correlated with
job satisfaction and attachment.
No statistically significant differences in reported
plans to leave and rural versus urban region were
found.
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – DENTISTS, 2008
Age (N = 613)
Mean (min, max, st dev)
51.5 (27 to 85, st dev = 10.7)
> 35 years
10. 3 %
36 – 50
33.1
51 – 64
47.5
65 +
9.1
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – DENTISTS, 2008
Geographic Location (Labor Market)
Residence Work
Aroostook and Washington
5.6%
5.6%
Piscataquis, Penobscot and Hancock
15.9%
16.0
Somerset, Franklin, Oxford, Kennebec
and Androscoggin
21.6
24.8
56.8
53.6
Urban (Cumb, Sag, York, Andro, Penob)
66.6
66.1
Rural (Aroostook, Franklin, Kennebec,
Knox, Piscat, Somerset, Waldo, Wash,
Hancock, Oxford, Lincoln)
33.4
33.9
Waldo, Knox, Lincoln, Sagadahoc,
Cumberland and York
Urban vs. Rural (County)
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – DENTISTS, 2008
Type of Practice Setting
Self-employed (solo or group practice)
80.9 %
Solo practice
63.8
Group practice
36.2
Private practice
83.0
Clinic, hospital, group plan facility
11.1
Military, VA, public health, Indian Health
facility
2.9
Medical Research Institute or
Establishment
0.5
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – DENTISTS, 2008
Weeks/Year and Hours/Week
Mean # of weeks worked/last year in Maine
(range, std dev) (N=589)
 Worked 35 weeks or less
47.4
(0-52, 9.4)
7.4%
Mean # hrs/wk, direct patient care (N= 596)
33.4 % (0-129)
Mean # hrs/wk, non-clinical tasks (N=596)
2.3 % (0-40, 4.9)
Mean # total hours/week (N=596)
35.8 (0-139, 13)
Working full-time (40 hrs +/week) (N=596)
40.3% (n=240)
Working part-time (less than 30 hrs) (N=596)
21.3% (n=127)
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – HYGIENISTS, 2008




Most Maine hygienists are white women between
35 and 54 years of age; mean age = 43.1
The typical hygienist in Maine has practiced for
18.9 years. About 26% of those surveyed had
been working for 10 years or less; about 20% had
been working for 30 years or more.
The average number of hours worked per week is
28.1; 41% worked fewer than 30 hours weekly. As
hygienists get older, they tend to work fewer
hours per week.
Where hygienists work is distributed fairly equally
among urban core areas, suburban areas, large
town areas and “small town and isolated rural
areas” (27.9, 29.7, 27.6, 28.7%).
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – HYGIENISTS, 2008

Older dental hygienists were most likely to say
they did not plan to still be working in their field
in ME in 5 years.




82% yes, 5% no, 13% maybe (regardless of age)
Largest proportions “no”: Sagadahoc & Franklin
Counties; largest number: Cumberland
Some differences in plans among urban core
areas (14%), suburban areas (8%), large town
areas (8%) and “small town and isolated rural
areas” (16%).
Hygienists who worked less than 30 hours/week
were somewhat less likely than those working
30+ hours/week to say they would be still working
in 5 years.
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – HYGIENISTS, 2008
Active Dental Hygienists by Age Group
(among those who responded to the survey)*
Age
Number
Percent
21 – 24
24
3%
25 – 34
147
19
35 – 44
226
29
45 – 54
225
29
55 – 64
117
15
65 – 74
13
2
2
<1
25
3
75+
Unknown
* Only responders to the survey included, N = 779; in early 2008, there
were 1130 licensed hygienists with ME addresses.
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – HYGIENISTS, 2008
County/area
Aroostook and
Washington
Surveyed
Employed
Workplace
32
27
32
136
124
130
Somerset, Franklin,
Oxford, Kennebec &
Androscoggin
146
139
138
Waldo, Lincoln, Knox,
Sagadahoc, Cumberland
& York
312
280
344
Urban Core
229
207
310
Suburban
119
110
49
Large Town
106
101
119
Small town/rural
172
152
65
Out of state or unknown
153
131
58
Piscataquis, Penobscot &
Hancock
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COOPERATIVE HEALTH MANPOWER
RESOURCE INVENTORY – HYGIENISTS, 2008
Primary type of
Practice
# of
hygienists
Percent
525
79
Periodontal practice
32
5
Public health
30
5
Clinic
27
4
Pediatric practice
15
2
Educational
institution/clinic
13
2
Orthodontic practice
5
1
Prosthodontic practice
4
2
General dental practice
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WHAT DOES THE DATA TELL US?
Our dental professionals are getting older.
 Our dental professionals live and work
where most of us do.




Compared to the national average, there are ~ 70%
fewer dentists per capita in Maine’s six rural
counties, and ~40% fewer hygienists.
The characteristics and distribution of our
dental professionals impact access.
Our dental professionals don’t like to
answer surveys.
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WHAT DO WE NEED FROM THE
DATA? HOW CAN WE USE IT?

Do we have enough dentists and
hygienists?
 Where do they live?
 What do they do (focus of
practice)?
 How much do they work (FTE)?
What would the impact of a “new”
practitioner be?
 ???

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RECOMMENDED ACTIONS/STEPS
Require more information on
licensure applications
 Need for meaningful questions
 Need to standardize questions
 Encourage participation in
voluntary surveys by licensed
practitioners
 ?????

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RECOMMENDED ACTIONS/STEPS
Find a home for health manpower
surveys; include dental professions
at same interval as medical
 Support the Board of Dental
Examiners in data collection efforts
 Agree on standards for collection
and reporting
 ???

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UNDERSTANDING THE DENTAL
WORKFORCE
Questions?
Comments?
Judith A. Feinstein, MSPH
Director, Oral Health Program
[email protected]
207/287-3267
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