The Health Services Researcher of 2020: A Summit to Assess the Field's Workforce Needs

Objective. To summarize the current state of the health services research (HSR) workforce and recommend ways to improve the field's ability to respond to future challenges facing the health system. Data. Summaries of workgroup discussions and recommendations at a stakeholder meeting. Study Design. In late 2007, 50 educators, students, employers, and funders of HSR participated in a meeting to discuss findings of three commissioned papers on the HSR workforce. The group undertook a consultative process to develop recommendations for the field. Principal Findings. Stakeholders developed recommendations in five major areas focused on HSR workforce needs: (1) improving the size and composition of the field; (2) understanding the growth of HSR in the private sector; (3) improving the graduate training of health services researchers, especially at the master's level; (4) expanding postgraduate training and continuing education opportunities; and (5) increasing awareness of the value of HSR. Conclusions. Specific recommendations in the five major areas emphasized developing partnerships between HSR organizations and other professional societies or health organizations, as well as ways to improve training for the future workforce. The need to develop a “client orientation” toward research by improving communication and dissemination skills was discussed, as was the importance of improving diversity in the field.     

Preparing the Health Services Research Workforce

Objective. To describe the ways in which investigators are trained for careers in health services research and estimate their number. Data Sources/Study Setting. Sources describing health services research (HSR) training were consulted and published inventories of HSR training programs were reviewed and 124 training programs were contacted and interviewed to determine the numbers of students and the content of their HSR degree programs. Study Design. Observational study. Data Collection. HSR programs listed by AcademyHealth were surveyed and asked for details of enrollments; course content was captured from websites for the remaining programs. Principal Findings. There are over 300 programs that train investigators in health services research in master's and doctoral programs. The number of graduates who become HSRs in any given year is unknown, but approximately 5,000 individuals graduate with skills that would allow them to function in or lead HSR projects and up to 200 fellows are annually trained as potential independent health services researchers. Conclusions. The training pipeline for HSR appears to match demand because there are no apparent shortages of skilled workers in the field. There are many forces that are pressuring the field to adapt to technology demands and the increasing need for “translation” of results from research into practice.     

Needs Assessment for Behavioral Health Workforce: a State-Level Analysis

This study describes trends in the supply and the need for behavioral health professionals in Nebraska. A state-level health workforce database was used to estimate the behavioral health workforce supply and need. Compared with national estimates, Nebraska has a lower proportion of all categories of behavioral health professionals. The majority of Nebraska counties have unusually high needs for mental health professionals, with rural areas experiencing a decline in the supply of psychiatrists over the last decade. Availability of robust state-level health workforce data can assist in crafting effective policy for successful systems change, particularly for behavioral health.     

The Health Services Research Workforce: Current Stock

Objective. To examine the size and characteristics of the health services research (HSR) workforce; the job satisfaction, job security, and future plans reported by the workforce; and the future of the HSR workforce supply. Data Sources. (1) AcademyHealth active and lapsed members since 2000 and annual research meeting presenters and interest group participants; (2) principal investigators of research projects listed in the HSRProj database; and (3) authors of articles published in two HSR journals. Study Design. Data on investigators conducting HSR in selected venues were collected and compared in order to identify the percentage of the HSR workforce represented in the “core” versus related disciplines and to investigate the extent to which the “core” researchers publish, present, or participate in disciplinary venues. Principal Findings. The field appears to have grown dramatically since 1995, from an estimated 5,000 health services researchers to an estimated 11,596 in 2007. This is a broad workforce characterized by various levels of involvement in the field. Some researchers self‐identify with the field of HSR, while others are associated primarily with venues related to specific disciplines. Many researchers who identify with HSR also publish in venues related to multiple other disciplines. Conclusions. The field may face future challenges related to demographic change, such as an aging workforce and an increased need for diversity. International collaboration appears common, and in the future the field may need to be defined internationally rather than nationally. At the same time, there are also many indications that HSR is a good field to work in. Health services researchers reported high levels of satisfaction with their profession and current employer, as well as little desire to change jobs and little concern about job security.     

基于病人视角的卫生服务质量评估研究趋势与需求分析

卫生服务质量评估是卫生服务质量信息公开与医疗保险论质计酬两个重要问题的共同关键点.国际卫生服务质量评估发展的一个重要方向是强调基于病人视角的评估,国内卫生服务质量评估虽然强调"以病人为中心",但其实是基于供方视角的"以病人为中心",在需方看来,这些指标可能只是远在"以病人为中心"的"圆周"上.另外,从理论上讲,卫生服务质量的好坏是病人满意度高低的前提,因此,卫生服务质量评估研究的价值更大.     

基于病人视角的卫生服务质量评估研究趋势与需求分析

卫生服务质量评估是卫生服务质量信息公开与医疗保险论质计酬两个重要问题的共同关键点。国际卫生服务质量评估发展的一个重要方向是强调基于病人视角的评估,国内卫生服务质量评估虽然强调以病人为中心,但其实是基于供方视角的以病人为中心,在需方看来,这些指标可能只是远在以病人为中心的圆周上。另外,从理论上讲,卫生服务质量的好坏是病人满意度高低的前提,因此,卫生服务质量评估研究的价值更大。     

Findings from an Assessment of State Title V Workforce Development Needs

To describe results of a 2008 assessment of Title V workforce competencies and training needs at the state level, and examine preferences and barriers related to available education and training opportunities. A web-based survey was administered May through August, 2008 to Maternal and Child Health (MCH) and Children and Youth with Special Health Care Needs (CYSHCN) program leaders in all 50 states, and U.S. jurisdictions. Forty-nine MCH (96%) and 44 CYSHCN (86%) programs and four territories completed surveys. A major focus of the survey related to competencies in six core domains: Public Health/Title V Knowledge Base, Communication, Critical Thinking, Management Skills, Family Centered Care and Medical Home, and Leadership Development. The top training needs identified by state Title V programs fall into the global category of critical thinking, including skills in MCH data synthesis and translation, in program evaluation, and in systems thinking. The need to enhance personal rather than organizational leadership skills was emphasized. Blended learning approaches (graduate education), and national conferences with skills building workshops (continuing education) were identified as preferred training modalities. Barriers to training included lack of career opportunities, insufficient agency support, and inability to take leave (graduate education), and travel restrictions, release time limitations, costs, and limited geographic access (continuing education). Both the focus of training and preferred training modalities differed from previous MCH workforce survey findings. Given the changing needs expressed by state Title V leaders as well as their training preferences, it is important that current and future graduate education and continuing education approaches be better aligned to meet these needs and preferences.     

对农民工公共卫生服务的认识和提供意愿研究

为了解基层卫生工作人员对农民工公共卫生服务的认识和提供服务的意愿,用填写意愿调查表和深度访谈的方法对成都市部分卫生工作人员进行了调查。结果表明,基层卫生工作人员对农民工公共卫生服务有比较客观的认识,但总体上服务提供意愿不强,服务主动性有待进一步提高。     

17所县以上医院临床医疗质量检查结果及分析

对１７所县以上医院临床医疗质量的检查结果进行分析,发现当前主要存在的问题及住院医师２４小时负责制、三级医师查房制、疑难病例死亡病例讨论制、手术前病例讨论执行不严,病历书写的内涵质量不高,滥用抗生素情况相当严重,学科建设和人才培训方面也存在不少问题针对上述情况指出,必须科 室建设,抓好制度产,制定重点学科建设规划、努力提高医务人员的素质。     

Employer Demand for Health Services Researchers in the Year 2020

Objective. To describe factors that will shape future demand for doctoral‐trained health services researchers. Study Design/Data Sources. Commentary based on recent trends in funding for health services research (HSR), the number of federally funded HSR projects listed in HSRProj, national expenditures for health, and interviews with a small number of employers. Principal Findings. Despite rapid growth in the overall health care sector, inflation‐adjusted funding for HSR has declined, implying little or no net growth in demand for people to lead HSR studies. Employers report being able to hire researchers to conduct HSR by drawing on people trained in many disciplines. Conclusion. Employers have considerable flexibility in hiring individuals to conduct HSR when demand is relatively stable. They may have much more difficulty hiring well‐qualified researchers when faced with sharp increases in demand for HSR, such as could be generated by recent economic stimulus legislation.     

Community Health Centers and Emergency Preparedness: An Assessment of Competencies and Training Needs

Community health centers (CHCs) provide care to a large number of medically underserved Americans. As primary care providers and trusted members of their communities, CHCs need to be prepared to respond to emergency and disaster situations, as they may be relied upon for medical care and other support services. Focus groups were conducted with CHC medical directors and administrators from New York City. Participants discussed previous emergency preparedness training, future training needs, applicability of competencies, and usefulness of two training programs. Participants indicated that they had more experience with preparedness training than many of their colleagues, although participants still reported further training needs. In particular, emergency roles and responsibilities, decontamination and containment, and personal preparedness were given as needed training topics for staff. The training resources were reported to be useful and beneficial. Participants also reported that most of the competencies were appropriate for CHC clinicians. During an emergency, people want to receive care from their normal provider, and for many, that provider is a CHC. This and other research suggests that the emergency preparedness needs facing CHCs are significant and should be addressed.     

Health Services for Special Needs Children in Pennsylvania Schools

ABSTRACT: School health programs traditionally have involved health services, health instruction, and a safe school environment. Likewise, school health services have been provided by nurses, physicians, and appropriate administrative personnel. In the 1990s, increased integration of primary care services through school-based clinics expanded traditional activities of school health programs. Consequently, more chronically ill children, particularly technology dependent children, have entered the regular school setting, requiring that schools be prepared to manage these chronically ill students who come to school with new morbidities and technological dependencies. This statewide survey examined the number and kind of special needs children in the regular school setting in Pennsylvania, as well as the personnel, programs, policies, and resources available to support these children. ( J Sch Health. 1994;64(6):258–260 )     

Youth with Special Health Care Needs: Transition to Adult Health Care Services

Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.