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 Joint Questionnaire

General practitioners (2211) - General practice

Specialist practitioners (2212) - General paediatrics - Obstetrics and gynaecology - Psychiatry - Medical group of specialties - Surgical group of specialties

Medical practitioners, not further defined (2210)

- 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.

Large variations in

general practitioners

Source: OECD Health Data 2011.

Per 10 000 population

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) General paediatrics Obstetrics & gynaecology Psychiatry Medical group Surgical group

Specialist practitioners (2212)

- General paediatrics - Obstetrics & gynaecology - Psychiatry - Medical group - Surgical group - Other specialties n.e.c.

Medical practitioners, not further defined (2210)

Other categories not elsewhere classified

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 by categories • Nurses

– 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)

Professional nurses Associate professional nurses

Titles of occupation

•Registered nurses (Australia, Canada, New Zealand, U.S.) •Registered psychiatric nurses (Canada) •Advanced practice nurses (e.g. nurse practitioners, etc.) (U.S.)

•Enrolled nurses (Australia, New Zealand) •Nursing assistants (New Zealand) •Licensed practical nurses (Canada, U.S.) •Licensed vocational nurses (U.S.)

Tasks •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.)

•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)

Education •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)

•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”