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Difficult-to-fill vacancies in selected health care disciplines in British Columbia, 1980-1991 MacDonald, A.; Kazanjian, Arminée 1947- Jun 30, 1993

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Difficult-to-Fill VacanciesIn Selected Health Care DisciplinesIn British Columbia, 1980 - 1991HHRU 93:5Health Human Resources UnitCentre for Health Services and Policy ResearchThe John F. McCreary Health Sciences CentreThe University of British ColumbiaVancouver, B.C. Canada V6T 1Z3A. MacDonaldA. KazanjianJune 1993REALTII HUMANRESOURCES UNITThe Health Human Resources Unit (HHRU) of the Centre for Health Services and Policy Research wasestablished as a demonstration project by the British ColumbiaMinistry of Health in 1973 . Since that time,the Unit has been carried on an ongoing basis within the Ministry's annual operating budget The Unitundertakes a series of research studies that are relevant to health human resources management and to publicpolicy decisions.The HHRU's researchagendais determined through extensivediscussions of key current issues and availableresources with the members of the Health Human Resources Working Group of the Ministry of Health.Various health care provider groups participate indirectly, through on-going formal and informalcommunication with Ministry of Health officials and with HHRU researchers.Three types of research activity are variously included on the Unit's research agenda and draw 00 differentskills and research expertisefrom its faculty and staff. In conjunction with the professional licensing bodies.or associations, the HHRU develops and maintains a co-operative health humanresources database. The Unituses these data. to produce regular status reports that: provide a basis for future in..<Jeptll studies and for healthhumanresources planning. The Unit conducts in-depth studies that have a particularpolicyrelevanceor assessthe impact of specific policy measures, based on secondaryanalyses of data.from the co-operative databaseor primary data collected through large-scale surveys. The HHRU also conducts specific projects pertainingto the management of health human resources at local, regional, or provincial levels.Copies of studies and reports produced by the HHRU are available at no charge.Health Human Resources UnitCentre for Health Services and Policy Research429 - 2194 Health Sciences MallVancouver, British Columbiavet lZ3 (604) 822-4810THE UNIVERSITY OF BRITISH COLUMBIAHealth Human Resources UnitCentre for Health Services and Policy Research429 - 2194 Health Sciences MallVancouver, B.C . Canada V6T 1Z3Tel: (604) 822-4810Fax: (604) 822-5690July 23. 1993Mr. Tom VincentChairmanHealth Human Resources Working GroupMinistry of Health1515 Blansbard StreetVictoria, B.C. V8W 3C8Dear Mr. VincentIt is with great pleasure that I transmit to you and the members of the Health HumanResources WorkingGroup the completed report "Difficult-to-Fill Vacancies in Selected Health Care Disciplines in BritishColumbia, 1980 - 1991". This is thesecond analytic summary of the Difficult-to Fill (OTF) vacancy datacollected quarterlyby the Health Human Resources Unit This second report encompasses twelve yearsof data, providing a longer term analysis of trends than its predecessor.The D'IF vacancy data are examined for both Registered Nurses and disciplines other than RNs. andanalyzed for possible trends in three forms: absolute numbers of vacancies, vacancy rates per 100 beds.and vacancy rates per 100 employedpersonnel. Comparisons are also made with ill claimantdata fromEmployment and Immigration Canada.It is a pleasure to thank once again the participating hospitals and agencies which have faithfully continuedthe data collectionover the years. The response rate, admittedly encouraged by follow-up telephone cans,has been maintainednear perfectWe look :forward to receivingcommentsand suggestions from the members of the WorkingGroup as wellas from other readers.Sincerely yours,41v/e..--rArminre Kazanjian,Associate Director(2-A Research Unit Funded by the Ministry of Health, British ColumbiaTABLE OF CONTENTSLetter of TransmittalList of Flgureslist OfTableslist of AppendicesPageI. Introduction 1AD.BackgroundDefinitions12II. Data Development 3A.B.Study PopulationData Collection36m. Results - Registered Nurses 7A.B.C.D.E.Region and Size of Facility .Nursing Area .Vacancy Rates per 100 Beds .Vacancy Rates per 100 Practising RNs .mc Statistics .79131522IV. Results· Other Health Personnel . 22A.D.C,D.E.Region and Size of Facility .•.............Occupational Group .Vacancy Rates per 100 Beds .Vacancy Rates per 100 EmployedPersonnel .mc Statistics .2225293436V. DIscussion 39ReferencesAppendicesReports of the Health Human Resources Unit4345Figure 1Figure 3Figure 4aFigure 4bFigure 5Figure 6aFigure 6bFigure 7Figure 8Figure 9Figure loaFigure lObFigure 11Figure 12Figure 13aFigure 13bLIST OF FIGURESDlF Study PopulationDlF Vacancies for Registered Nurses by Region and Size ofFacilit:y. 1980 -1991 4 , t •• , ••• , .Percentage Distribution of DlF Vacancies for Registered Nursesby Region and Size of Facility, 1980 - 1991 .....•.•............•.D'IF Vacancies for Registered Nurses in Three Problem Areasby Year, 1980 - 1991 ........... .. .................•.......DTF Vacancies for Registered Nurses in Three Problem Areasby Year, 1980 - 1991 ....... .....................•.........DTF Vacancies for Registered Nurses per 100 Approved. Beds,by Region and Size of Facility, 1980 -1991 .DTF Vacancies for Registered Nurses per 100 Approved Beds,by Nursing Area for Three Problem Areas, 19S0 - 1991 .D'IF Vacancies for Registered Nurses per 100 Approved Beds,by Nursing Area for Three Problem Areas, 19S0 - 1991 .Number of ill Claimants versus Number of D'IF Vacancies forRegistered Nurses, 1986 - 1991 .DTF Vacancies for Other Disciplines by Region and Size ofFacility, 1980 - 1991 ........... ..... ........•..............Percentage Distribution of D'IF Vacancies for Other Disciplinesby Region and Size of Facility, 1980 - 1991 .DTF Vacancies for Other Disciplines by Discipline, 1980 - 1991DTF Vacancies for Other Disciplines by Discipline. 1980 - 1991Number of DlF Vacancies for RNs, LPNS/Orderlies, andNurses' Aides, 1980 -1991 .DTF Vacancies for Other Disciplines per 100 Approved Beds,by Region and Size of Facility, 1980 - 1991 ....................•.DTF Vacancies for Other Disciplines per 100 Approved Beds,by Discipline for Three Problem Areas. 1980 - 1991 .DTF Vacancies for Other Disciplines per 100 Approved Beds,by Discipline for Three Problem Areas, 1980 - 1991 .48101112141617232426272830313233Figure 14Figure 15LIST OF FIGURES (continued)Number of mc Claimants for Other Disciplines, 1986 - 1991Number of mc Claimants for Nursing-related Disciplines.1986 - 1991 , .3738Table 1Thble 2Table 3Table 4LIST OF TABLESClassification of 117 Current Respondents by Health HumanResources Unit Health Regions and Hospital Bed Size . ........•.....Classification of 117 Current Respondents by Functional Categoryof Beds ... ................................... ......•...Difficult-to Fill Vacancies per 100 Practising Registered Nurses. by Nursing Area and Region of Facility, 1980 -1991 .Difficult-to Fill Vacancies per 100 Employed Personnel forSelected Disciplinesby Region of Facility, 1980 -1991 .552035LIST OF APPENDICESAppendix A Map of Regional Hospital DistrictsAppendix B Number of Dlffieult-to-Flll Vacancies for Registered Nurses.1980 - 1991Appendix C Number of Dlfficult-to-Fill Vacancies for Other Disciplines.1980 - 1991Appendix D Approved Bed Capacity for D'IF Facilities. by Size and Regionof Facility, 1980 -1991Appendix E Number of Practising Registered Nurses Employed in the StudyFacilities, by Nursing Area and Region of Facility, 1980 - 1991Appendix F Number of Employed Personnel for Selected Disciplines.by Region. 1980 ~ 1991I. INTRODUcnONA. BackgroundThis report is the second of its kind presenting a summaryand synthesis of the data collectedby the Health Human Resources Unit (HHRU) on difficult-to-flll (DTF) vacancies in British Columbia.The first summary report was completed in 1987 following the first seven years of data collection; thisreport incorporates five more years of continuous data. covering a twelve-year period.The "Difficult-tn-Fill" study began in January 1980 followlng discussions in 1979 between theBritish Columbia Health Association (BCHA) and the Health Human Resources Working Group(HHRWG), at the time comprising the ministries of Health, Post-Secondary Education. Universities,and Labour. These discussions were undertaken in response to mounting pressure from numerousreports in British Columbia newspapers during 1979 and 1980 of a nursing shortage. However, therewas no available empirical evidence at the time for these claims. This project was thus establishedtomonitor wunet demand for health personnel In British Columbia with a focus on nursing personnel butalso to include a large number of other health care disciplines.During 1980, survey data were collected on a monthly basis with monthlyreports on theflndlngs, prepared and"distributed to the participants and government officials. From 1981 to 1983data were collected monthly but reports were prepared on a three-month basis. Since 1984 the datahas been collected in spot counts at the end of the quarter (March, June, September, and December)and survey reports prepared on a quarterly basis. 'These quarterly reports have always been descriptiveaccounts of the current situation only. The first summary report (Kinnls, 1987) presented a descriptionof the data collected over the entire seven year period and a brief analysis of the trends over that timeframe. This report continues that examination of trends in unmet demand for health personnel inBritish Columbia1B. DefinitionsDifficult-to-Fill (Dm Vacancy: A vacancy in any health care related field which has been inexistence for at least one month, and for which, during that period, there has been active recruitmentwithout hiring a suitable applicant Vacancies for casual and/or temporary positions are not included.GVRHD: Refers to the Greater Vancouver Regional Hospital District as defined by the Hospital Caredivision, B.C. Ministry of Health. It includes Burnaby, Coqultlam, Delta, Langley, New Westminster,North Vancouver, Port Coqultlam, Port Moody, Richmond, Surrey, Vancouver. and West Vancouver(See map of British Columbia in Appendix A).Other B.C,: Refers to the remainder of the province of British Columbia outside of the GVRHD.Registered Nurse (RN): Throughout this report, the designation "Registered Nurse" includes bothRegistered Nurses and Registered Psychiatric Nurses. unless otherwise noted.Vacancy Rate per 100 Beds: This is calculated by taking the number of DlF vacant positions as thenumerator, and dividing it by the number of approved beds contributed by the responding facilities,and multiplying the result by 100. Where comparisons are made based on region and size of facility ,the denominator is also based on region and size of facility; otherwise, the denominator is based onthe total number of beds contributed by all respondents,Vacancy Rate per 100 PraetisinglEmplayed Personnel: This is calculated by taking the number ofDTF vacant positions as the numerator, and dividing it by the number of personnelpractising/employed in that area/discipline, and multiplying the result by 100.2II. DATA DEVELOPMENTA. Study PopulationWhen the Dlfflcult-to-Flll survey began in 1980, a population of 132 facilities and agenciesexisted in British Columbia, including all hospitals listed by the Hospital Care Division of the Ministryof Health. two large government hospitals, and selected agencies. Of the 132, one of these neverresponded, leaving a working survey population of 131. Of these, 120 facilities/agencies respondedregularly; 6 joined the survey late (3 In mid-1980, 2 in early 1981, and 1 in early 1983); and 5 leftduring 1980-81 (2 closed and 3 withdrew), leaving apopulation of 126 facilities/agencies whichresponded regularly from 1983 until mid-1988. At that time another agency withdrew and thepopulation dropped to 125. In 1990, due to the amalgamation of several hospitals under varioussocieties, the study population decreased to 122, although the same hospitals were all still included inthe survey. For consistency in reporting, 6 outlying small hospitals which are part of the CanadianRed Cross Society were combined in 1991 under one society to give the current (as of December1991) study population of 117 :facilities/agencies. The historic composition of the study population Issummarized in Figure 1.The classification of the current respondents by size of facility and HHRU Health Region (seeAppendix A) is shown in Table 1. About one-quarter (24.8%) of all facilities/agencies and 64.3percent of the large facilities (400+ beds) are in the Greater Vancouver Regional Hospital District(GVRHD). The Capital District contains 4.3 percent of the facilities, with the remainder in other areasof the province. The majority of all facilities (73.5%) are small in size. with fewer than 200 beds.A description of the functional category of beds for current responding instltutlons is providedin Table 2. Just over 80 percent of the facilities/agencies are acute care - with or without longer stayor rehabilitation beds. Longer stay beds (primarily extended care beds) are present in 70 percent ofthe faci.1i ties.3Figure 1DTF Study Population1980 -1991132Facilities &Agencies(1980),131... (-\ NeverR~ponded J120Regular Respondents126Respondents(1980 - 1986)2 CJosed&3 Withdrew in 1980-81_ ( 1 AgencyI-------~l Withdrew in 1988,125Respondents,iI122Respondents-Amalgamation of5 Hospitals into2 Societies in 1990I-- ~...( Combining of 6 Hospitals )\ Under 1 Society in 1991,iI117Respondents(1991)4Table 1CJassification or 117Current Respondents,by HHRU Health Reglon', and Hospital Bed Slze2Number ofApproved BedsHHRUHea1th None or Total TotalRegion. 400+ 300-399 200-299 106-199 50-99 <50 Not Rated N %OVRHD 9 4- 3 6 4- 0 3 29 24.79Capital 2 0 1 1 1 0 0 5 4.27FraserVallcy 0 1 2 1 1 1 0 6 5.13OkanllBIID 1 1 1 1 1 ~ 1 9 1.69South East 0 0 1 I 8 8 1 19 16.24IsIlIDd Coast 1 0 2 4 a 10 2 19 16.24-Central 1 0 0 2 0 1 1 11 9.40North Central 0 1 0 1 2 8 1 13 11.11North 0 0 0 a 3 ~ 0 6 5.13TOTALN 14 7 10 11 20 40 9 111 100.00% (12.0) (6.0) (8.5) (l4.5) (17 .1) 04.2) (7.7) noomI Regional Hospital IfutrictB have been grouped by the HHRU in order to provide a aufficicot base foranalyaiB of health personnel groups. Sec map of B.C. in Appendix 1 for location of fegiODI.2 Number of approved bcda as listed by the Hospital Care divirion of thoB.C. Miniatry of Health, for March 31, 1991.Table 2Classification of 117 Current Respondentsby Functional Category ofBedsFunctional Category of BedsAcute Care OnlyAcute Care + Longer Stay 1Acute Care+ Longer Stay + Rehab.Acute SubtotalLonger Stay OnlyRehabilitation 2PtychillmcHoldiDg BedJ Only 3Other Facilities 4TotalNumber266629411316211722.2256.411.71tro.349.402.560.855.131.71100.00I Includes extended, intermediate, and personal care.:I With or without extended care.S Diagnostic &: Treatment Centres and Canadian Red Crosa Society.4 Warker', CompensationBoard of B.C. and The Arthritis Society (B .C. Division).58. Data CollectionDuring 1980. data collection was on a monthly basis with the use of two forms. On the firstform participants listed any vacancies that had become difficu1t-m-ffil during that month (1. e. vacant30 days or more and for which there had been active recruitment). The second form was a computer­generated list of their previously reported difficult-to-fill positions on which they were to indicatewhich ones had been filled during that month. 'This allowed vacancies to be tracked longitudinally.Information was collected on the reason for the vacancy and the required qualifications. as well as thetype of position (full-time or part-time) and the nursing area (RNs) or specific discipline (other healthpersonnel) of the vacancy. Monthly reports were sent during the fIrst year of the survey.For the next three years (1981 - 1983) data were collected in the same way except that thesurvey forms and the reports were distributed every three months (March. June, September, andDecember) rather than every month.From 1984 onward. the DTF report consisted of a simplified spot count of the difficult-to-fillvacancies in existence on the last day of the quarter. Information on the number. type of vacancy(full-time or part-time), and the area of nursing or specific discipline are the only data collected Inthese "spot counts". 'The "spot counts" of dIfficult-to-fill vacancies are still ongoing and the results arepresented in quarterly reports.For the purpose of comparing data over the entire twelve yearperiod, the longitudinal datacollected from 1980 to 1983 were examined and simple records extracted and computer-filed for eachreport-month to produce "spot counts" of difficult-to-fill vacancies similar to those from 1984 onward.For example, if a given vacancy became difticult-to-fillin June 1981 and was filled in November1981. a record would be filed for each of the two end-of-quarter months. June and September.The number of vacancies in each of the four quarters for each year were then summedto givethe number of vacancies for each year. which form the basis for most of the tables and figuresincluded in this report Appendices B and C contain the number of D'IF vacancies for Registered6Nurses and Other Disciplines respectively.In order to undertake 'pooled' time series analysis and examine trends over time, variousmethods of calculating vacancy rates were considered. 'The numerator (number of vacant positions)has been refined over the study period, but it has been more difficult to find an appropriatedenominator. 'The number of approved beds in the reporting facilities/agencies as listed by theHospital Care Division of the Ministry of Health (see Appendix D) has been used as the denominatorfor vacancy rate calculations in the quarterly reports since the reports began. In this report, like thefirst summary report (Kinnls, 1987), an attempt has also been made to calculate vacancy rates for RNsusing the number of practising RNs (see Appendix E) as denominator; this number is estimated bynursing area as listed by the Registered Nurses' Association of British Columbia (RNABC), For otherhealth disciplines, the rate is estimated using the respective numbers found in the ROLLCAlLpublications (see AppendixF).This report also compares vacancy trends to trends in data about unemployment insuranceclaims (from 1986 ~ 1991) for various health personnel, as reported by Employment and ImmigrationCanada (Regional Economic Services Branch for B.C. & Yukon Region), Unemployment insurancedata are based on "Regular Claimants". A claimant is a person who has an open and establishedclaim, regardless of whether or not he or she Is receiving benefits, and 'regular' excludes those claimsthat are based on sickness or maternity.III. RESULTS - REGISTERED NURSESA. Region and Size of FacilityFigure 2 shows the trends in the number of difficult-tn-fill vacancies for RNs from 1980 to1991 by region and size of facility. The first peak. in the number of vacancies was in 1981 as reportedin our earlier summary report. along with the rapid decrease in vacancies seen during 1982. Theincrease in the number of vacancies which was just beginning at the time of the last report can now be7Figure 2DTF Vacancies for RNsby Region and Size of Facility, 1980 ~ 1991AURNs~~ . - ........OtherB.C. • /,' _ _ <," ----- ," "-- ~~ '-- . - . - . - . . . ' - - - . -- - rr> -.: : • '- \......... - -- . - /,"-- ......, . '""01;.._• • .....-: - , - Oth B C - --:. _. -. ....... ~- . _: :-: ':. --=- - - . . er. . ~ 1 ...- . - =- ..:.:~ - - -- ;-- == =--~ 0;::"":. •• - - - 400+- - - -... -.----- e.___ ___ -GVR.HD400+-0..<,/.\/.\•/',GVRHD<400./'- ./.\/\160012001400l1'tI 1000=QCl I"CIl~~ 800Clb~c 600Z40020001980 1981 1982 1983 1984- 1985 1986Year1987 1988 1989 1990 1991-',-.seen to have peaked in 1989, and as with the earlier peak of 1981,1t has since undergone a largedecrease through 1990 and 1991. Each of the four (region and size) dlsaggregated categoriesillustrated in Figure 2 also follow these same trends. although the peaks for GVRHD in 1981 and 1989most closely follow the peaks for all RNs of the sameperiod.The percentage of difficult-to-fill vacancies in each of the four region and size groupingsIncluded in Figure 2 is illustrated in Figure 3. The majority of vacancies has consistentlybeen in theGreater Vancouver Regional Hospital District (GVRHD) 400+ bed facillties. 1be <400 bed faci11tlesin the GVRHD accounted for the next highest proportion of the vacancies in 1982, 1983, and 1986­1991, The <400 bed facilities outside the GVRHD accountedfor the second highest proportion ofD'IF vacancies in 1980-1981 and 1984-1985. The smallest proportion of vacancies was usually seenin the 400+ bed facilities outside the GVRHD.B. Nursing AreaFigures 4a and 4b show the trends in the number of dlfficult-to-flll vacandes for RNs from1980 to 1991, dlsaggregated by area of service for the six most common problem areas. In all theother nursing areas, the number of vacancies ranged from 0 to 101 over the twelve year period. andsuch fluctuations usually followed the overall RN trend very closely. Of the six problem areas, all butBCD/Geriatrics appear to have contributed to the peakin the number of vacancies for RegisteredNurses that was seen in 1981. The 1989 unprecendented peak in overall DTF vacancies can beattributed to ICU/CCUIPAR, General Nursing, Mediclne, and Surgery. ECU/Gertatrlcs shows aslightly later peak occurring in 1989 and 1990, compared to an earlier 1988 peak for Psychiatry, apeak related to institutional, not community-based, vacancies. Although the number of extended carebeds in the province has increased consistently throughout the period. from 5,694 in 1980 to 7,801 in1991 (ROllCAlL UPDATE 80, ROll.CAlL 91), the number of difficult-to-fill vacancies inBCU/Geriatrics has tended to follow the overall trend seen for Registered Nurses in the province and9'""'o100%90%80%70%rl"CCl 60%~~ 50%~0-Clg 40%1=-030%20%10%0%Figure 3Percentage Distribution of DTF Vacancies for RNsby Region and Size of Facility, 1980· 19911980 1981 1982 1983 1984 1985Year1986 1987 1988 1989 1990 1991I_ GVRHD 400+ l1li GVRHD <400 IIIIII OtherB.C.400+ 0 OtherB.C. <400 IFigure 4aDTF Vacancies for RNs in Three Problem Areas,by Year, 1980 -1991350. ", \..\-,"..,-.".'-'.~ .MedicineSurgery-.......... ~-. --.......... -" -. --........ - ~-..-.-~ - -_.o I i I I I I I Iii I •50300250II"D~ I 8200'""" ~"""e~ 150:lZ1001980 1981 1982 1983 1984 1985 1986 1981 1988 1989 1990 1991YearPsychiatry350300250tl"D~ I l:l~ f! 200~....Q1150~Z10050Figure4bDTF Vacandes for RNs In Three Problem Areas,by Year, 1980 -1991<,I ........ <,I "I \I \I ~\ . -,I ,..- \ 'I,,' \ ..- .--II "........ __. __. _ f - . - • ECUlGeriatrics......... ,'. ,- I-. ....... ,'-'- ". - . - - ."""'--..: ' , . " .______ -----.11980 1981 1982 1983 1984 1985Year1986 ·1987 1988 1989 1990 1991has not varied as a function of extended care beds. In retrospect, the relatively smaller peaks in thenumber of vacancies in 1984 and 1986 for all RNs appear to be a function of the lesser increaseinvacancies seen in General Nursing and especially ICU/CCUIPAR nursing areas.c. ·Vacancy Rates per 100 BedsUsing hospital bed capacity as a denominator in calculating vacancy rates for RegisteredINurses puts the numbers in historic context (Figure 5); if changes in the vacancy rates were simply inresponse to changes in bed capacity, Figure 5 would not so closely resemble Figure 2. For theprovince as a whole, the peaks in the number of vacancies which occurred in 1981 and 1989 remainsignificant when the vacancy rate per 100 beds is examined. 'The vacancy rate was on tbe increaseand peaked in 1981 at 4.1, and again peaked in 1989 at 1.4, while the denominator, bed capacity, wasalso on the increase in both 1981 and 1989~ yet in the subsequent year immediately following the peak:years. when the vacancy rates dropped sharply (1982.and 1990), the bed capacity remained more orless constant. Of course, bed capacity Is an official statistic established by the Ministry of Health andmay not correspond to the actual number of beds in the province at any time.The sharp drop in vacancy rate which occurred in 1982 coincided with the decade's earliestimposition of fiscal restraint on hospitals, when the B.C. Ministry of Health stopped funding hospitalson a per diem basis and changed to "global" funding in 1981/82 (Rauen, 1992). The decline in thevacancy rate that occurred in 1990 through 1991, interestingly. coincided with the B.C. MInistry ofHealth's next attempt at a more appropriate funding strategy when they introduced the"population/demographic" model in 1989190 (Haazen, 1992). We assume that in both situations, theuncertainty of funding level is a factor hospital management takes into consideration; the short-termreaction to it is the elimination of vacant positions and closing of beds, if necessary.Comparing the vacancy rates based on the region andsize of the facilities Illustrates that D1Fvacancy problems were most severe in the GVRHD, especially in the 400+ bed facilities whose13.Figure 5DTF Vacancies for RNs per 100 Approved Beds,by Region and Size of Facility, 1980 - 19911412,10C=20GVRIID/400+\/ \\/ \Other B.C.<400/\GVRHD<400— ,— . AI1B,Other B.C.400+\\—.\/—1980\1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991Yearvacancy rate was always above the provincial vacancy rate. The vacancy rate per 100 beds in theGVRHD <400 bed facilities rose above that in the GVRHD 400+ bed facilities in 1986 - 1987, due tothe large increase in the number of DlF vacancies in the GVRHD <400 bed facilities. The percentageof vacancies which occurred in the GVRHD <400 bed facilities in fact reached its maximum for thestudy period in 1987 at 27.7 percent of all vacancies for that year (Figure 3). The vacancy ratesoutside the GVRHD were always lower than the provincial vacancy rate. However, unlike the trendseen in the numbers of DlF vacancies, where the numbers of vacancies were greater in the Other B.C.<400 bed facilities than in the Other B.C. 400+ bed facilities. the vacancy rates per 100 beds were lessin the Other B.C. <400 bed facilities in all years but 1980 and 1984. In the years 1980 and 1984. thepercentage of vacancies which were found in the Other B.C. <400 bed facUities reached the highestlevels for the study period. at 27.7 percent of all vacancies in 1980 and 21.4 percent of all vacanciesin 1984 (Figure 3), compared to an average of 15.2 percent over the twelve year study period.Figures 6a and 6b illustrate the vacancy rate per 100 beds by nursing area of service for thesix most common problem areas. These figw-es are almost identical to Figures 4a and 4b whichshowed the absolute numbers of vacancies for the same nursing areas. The same trends seen inFigures 4a and 4b are also present in Figures 6a and 6b, indicating that the change in number of bedsin the province did not have an impact on DTF vacancies during the period under study.D. Vacancy Rates per 100 Practising RNsCalculating vacancy rates allows us to compare data across time. by removing underlyingchanges such as the dlanging bed capadty discussed in the last section. or changes in the number ofemployed personnel. In order to discover whether changes that occurred in the number of practisingRNa employed in nursing (supply) over the study period (1980 - 1991) had any effect on the Difficult­to-FIll vacancies (unmet demand), the vacancy rates per 100 practising RNs were calculated (fable 3).Since the numerator (number of DlF vacancies) includes both Registered NUrses and15Figure 6aDTFVacancies for RNs per 100 Approved Beds,by Nursing Area for ThreeProblem Areas, 1980. 19911991General1990/198919&819811986,...."',.... ~ \,.... , '\-: .:' "'\",' ."'.' ~~ .' "- - - , .- - .....- --- . ...... .- .. -_.- -..:..- " ,Surgery ~.19851984198319821.61.4! 1.2S 1.... I lQ\ ~l:! 0.8ij>CleIII 0.6>~Q 0.40201980 1981YearFignre6bDTF Vacancies for RNs per 100Approved Beds,by Nursing Area for ThreeProblem Areas, 1980 - 19911.6BCUIGe:riaIrics... - .. ..r-;<,I . .........Psychiatry I '\I \I \I \I ,- ~ . . ""\- -'.,I " \ '.I -'-I_ . ~ . . ·-t·- - - - _. I__ _ _ - ---J<,<,'.-;/ \/ /\. \\~~021.4i 128>-4 1l!~ 0.8~s:l~ 0.6;>-~l:l 0.4....-.J1980 1981 1982 1983 1984 1985 1986 1981 1988 1989 1990 1991YearRegistered Psychiatric Nurses. the denominator should do likewise. and include both RNa employed innursing and RPNs employed in nursing. The number of practising RNs employed in nursing wasobtained using RNABe registration data. 'There are some difficulties which occurwhen matching theRNABC categories for nursing area to the DTF survey categories. so that it 15 necessary to group DTFcategories for comparison purposes. As a result. information about important areas such aslCU/CCUIPAR. Medicine. and Surgery is lost within the one large gr~uping of MediclneiSurgery,along with information about other areas such as Emergency, OR. Cardiology. and Spinal Unit. Also.the .nursing area categories listed by the RNABC on their annual registration renewal forms tend tochange from year to year, leading to inconsistencies in the number of RNs included in categories fromone year to the,next, a problem we are unable to correst for, but which must be consisdered wheninterpreting the data.Major difficulties occurred when we attempted to include the number of RPNs employed innursing in the denominatorof the vacancy rate calculations. using RPNABC registration.data as foundin the ROLLCAlL andROLLCALL UPDATE publications. The first problem was the lack of datafor the years 1980, 1982, 1984, and 1986, as RPNs were not included in ROLLCAlL UPDATE priorto 1988. The next difficulty was the inconsistencies over the years in the data which were available.For 1981 and 1983, the available data include RPNs who were registered as 'active' but mayor maynot have been employed in nursing, while no information was available by nursing area. For the years1985, 1987, and 1988 the available data were for RPNs registered as 'active' who mayor may nothave been employed in nursing, but a breakdown of the data by nursing area did exist. The year 1989marked the introduction of a change in registration to 'practising' from 'active', but the available dataon nursing ar~ stilllncluded both RPNs employed and not employed in nursing. In 1990 and 1991,data comparable to those from the RNABC, using the categories 'practising' and I employed innursing' were available for RPNs and came disaggregated by nursing area. As with RNs, there werealso difficultles in matching RPN nursing area classifications to those for D'IF vacancies.18Due to all the problems with the data on -RPNs. it was decided not to include the number ofRPNs employed in nursing as part of the denominator in the calculation of the vacancy rates for Table3. The same decision was made by Barer et al, 1984 and Kinnls. 1987 in their reports on Difficult-to­Fill vacancies. In general. excluding the stock of RPNs from the denominator will cause a slightupward bias in the vacancy rates. 1b.is should be taken into consideration when interpreting the resultsshown in Table 3.The provindal vacancy rate per 100 practising RNs peaked in 1981 at 8.88 andin 1989 at12.00, and followed the same trends as seen previously for both the absolute number of vacancies(Figure 2) and the vacancy rate per 100 beds (Figure 5). The changes which occured in the number ofpractising and employed Registered Nurses (see Appendix E) did not therefore appear to affect thepatterns seen in the Difficult-to-Fill vacancies, 'The vacancy rate per 100 practising RNs In theGVRlID was greater throughout the study period than the provincial vacancy rate, indicating that thegreatest DTF vacancy problems were in the GVRHD. while the vacancy rate outside the GVRHD wasalways less than the provincial rate. The GVRHD vacancy rate per 100 practising RNs peaked in1981 and 1989. but outside the GVRIID there was no 1981 peak. Since the changing trends in thenumber of practising RNs employed in the DTF study facilities were the same for both the GVRIIDand Other B.C. regions, the early peakin the vacancy rate ouside the GVRHDin 1980 must be dueinstead to an increase in the number of D1F vacancies. Figure 3 supports this. as the percentage ofDTF vacancies outside the GVRHD was-greatest in 1980.When we examined the DTF vacancy rate per 100 practising RNs for different areas ofnursing, the nursing areas which most closely follow the provincial trend, and are therefore likelymajor contributers to the provincial trend, were delineated: General Nursing and Medicine/Surgery.In both of these nursing areas, the vacancy rate per 100 pr1lCtising RNs in the GVRHD was alwaysgreater than the rate outside the GVRIID. The largest vacancy rates per 100 practising RNs were seenin the GVRIID region in the areas of General Nursing and Psychiatry; General Nursing peaked in19Table 3Difficu.lt-to-Fill Vacandes per 100 Practising RNSl tby Nursing Area and Region of Facility, 1980 • 1991YearNursing Area Region 1980 1981 1982 1983 1984 1985 1986 1987 1988 1.989 1990 l.991General 2 GVRHD--- -21.53 13.42 38.26 17.83 40.66 99.06 69.54 5.25Other B.C. ----4.93 1.82 15.84 9.15 22.49 36.38 11.93 2.60MedlSurg 1 GVRlID 7.48 ,11.59 4.35 3.62 4.55 2.09 6.18 9.01 8.27 13.21 8.77 1.66Other B.C. 3.14 4.44 0.90 0.59 1-48 1.56 2.55 2.30 4.50 4.42 2.43 1.08Psychiatty GVRHD 12.93 70.32 11-64 1.26 2.13 0.68 2.19 0.00 71.94 45.86 33.21 33.25Other B.C. 6.17 8.36 2.82 0.55 0.00 1.74 2.53 4.36 4.15 5.85 1.61 1.53Paediatrics GVRlID 0.65 2.12 0.31 0.00 1.95 2.78 22.56 21.45 22.17 13.36 6.57 2.17Other B.C. 5.07 1.53 0.83 1.11 0.36 0.00 0.78 1.21 2.93 9.29 3.50 0.00Obstetrics GVRHD 0.64 3.38 2.32 7.43 1.18 1.12 0.00 0.33 2.51 7.81 1.32 0.14Other B.C. 3.21 2.57 1.00 1.42 0.35 1.04 0.91 2.52 1-98 3.00 1.81 0.68~ GeriatrlcsIECU GVRlID 19.24 7.87 2.73 1.22 6.10 2.72 5.20 6.87 6.73 18.14 21.40 3.600 Other B.C. 2.06 0.83 0.50 0.00 1.25 0.58 3.46 2.18 5.12 4.94 1.24 1.04Administration GYRlID 0.91 3.46 0.61 4.01 2.83 2.37 2.65 0.59 1.41 7.43 0.27 1.10Other B.C. 4.65 2.45 1.04 0.50 1.36 1.63 0.00 0.00 0.30 1.27 1.24 0.59Otber 4 GVRHD 5.22 3.21 1.13 0.89 4.90 15.09 18.80 11.28 9.77 11.47 7.74 1.61Other B.C. 0.56 0.51 0.00 0.62 3.85 1.63 8.33 22.74 1.87 1.43 0.40 0.71Total GVRHD 7.93 12.71 4.60 4.11 4.35 2.56 7.13 8.29 11.64 15.80 10.52 3.09Other B.C. 5.16 4.90 1.22 0.97 1.58 1.37 3.67 3.16 5.66 7.22 2.99 1.10Total 6.51 8.88 2.99 2.67 3.07 2.02 5.58 6.00 9.01 12.00 1.30 2.23I Includes only data on RNs (see text), from RNABC registration datafor practising RNs employed in the study facilities on a full-time or part-time ba&is(excluding casual), In June of each of the years 1980 to 1991.1 Includes the DTF category of General; andtheRNABC categories of General P.ractice, and 'Several Areas' (includes float, smaIlhospital, andcommunity).The RNABC categories of General Practice andSeveral Areas did not exist between 1980 and 1983.1 Includes the DlF categories of Medicine, Surgery, lCUICCUIPAR., OR, Emergency, Spinal, Cardio-thoracic, andCardiac Surgery & TransplantIncludes the RNABC categories ofMedicinelSurgery, MediciDelSurgery Specialties. Critical Care, OR. PAR, andF..mergency.'" Includes the DlF categories of Rehabilitation and Misce1lBneous. Includes the RNABC categories of Occupational Health, Research, Teaching(all categories), and Other Patient Care. The RNABC categories of unspecified 'DirectPatient Care' and 'Unknown' were distributed proportion.aD.yamong the other categories.1989 with 99.06 DTF vacancies per 100 practising RNs, and Psychiatry peaked in 1988 with 71.94DTF vacancies per 100 practising RNs. The area of General Nursing shows the greatest fluctuationsfrom year to year in the vacancy rates, matching the pattern seen for the number of DTF vacancies(Figure 4a) and for the vacancy rate per 100 beds (Figure 6a). For the nursing areas of Paediatrics,Obstetrics. and GerlatrlcsIECU, the vacancy rates In the GVRHD peak at times other than 1981 and1989, when most of the peaks in the vacancy rates occurred. The peak in the vacancy rate forPaediatric nursing seen in 1986 - 1988 in the GVRHD matches the peak: seen in the number of D'IFvacancies for Paediatrics at that time. The same is true for the Obstetric nursing peak .in vacancy ratein 1983, and thepeaks in the vacancy rates for GeriatrlrJECU nursing in 1980 and 1990; they matchcorresponding peaks in DTF vacancies in these areas, and are not due to changes10 the number ofpractising RNs employed10 the facilities.The absolute numbers of DTF vacancies included in the Medicine/Surgery category accountedfor the largest percentage of vacancies 10 an years but 1991 (see Appendix B), appearing to indicatethat this was the area of nursing with the most severe DTF situation. Calculating the vacancy rates per100 practising RNs for Medicine/Surgery put the situation 10a better perspective. demonstrating that arate in 1989 of 13.21 per 100 practising RNs was much less formidable than a rate of 99.06 forGeneral Nursing in the same year. Regrettably, data are not available to examine the vacancy rate per100 practising RNa for the different nursing areas subsumed under the Medicine/Surgery category toexamine which of these nursing areas, if any, did have large D'IF problems. "Other" Is the onenursing area.in which the peaks in the vacancy rates per 100 pcactislng RNs do appear to be causedmore by changes in the number of pcactising Registered Nurses than in the number of DTF vacancies.The large Increase in the vacancy rates for the Other nursing area coincided with changes in theclassification of nursing areas by the RNABC in 1984. Between 1984 and 1987, the RNABC removedits category of 'OtberINot Specified/Other Patient Care' from the classification scheme, causing adramatic decrease in the number of practising RNs who would ordinarily have fallen into the Other21category (see AppendixE). and consequently the increase in estimated vacancy rates per 100pcactlsing RNs seen in Table 3.E. Unemployment Insurance Claimant StatlstlcsFigure 7 shows the number of Registered Nurse (both the Nursing Supervisor and the GraduateNurse groups combined) ill claimants in relation to the number of DlF vacancies for RNs from 1986to 1991. From March 1986 to June 1988, as hospitals reported more D'IF positions. m claimantnumbers were on the decline. 'Ibe reverse was true from December 1990 to December 1991. when VIclaimant numbers grew as RN vacancies decreased. From September 1988 to September 1990,however, both the number of DTF vacancies for RNs and the numberof RN UI claimants increasedTheoretically, a large number of nurses looking for work should have resulted in a reduction in thenumber of DTF vacancies, instead of the large reported increase. No conclusions can be drawn, ofcourse. without further information on the types of OTF vacancies, the training/experiencerequirements for those vacant positions. and the educational/occupational profile of the UI claimants.It is interesting that the number of ill claimants rose first, and very abruptly. between June 1988 andSeptember 1988, not to be followed by a similarly precipitous rise in DTF vacancies until March toJune 1989.IV. RESULTS - OTHER HEALTH PERSONNELA. Region and Size of FacnttyThe trend in the number of dlfficult-to-:ti1l vacancies for health personnel other than RegisteredNurses follows the same pattern as t1:ult: seen for RNs overall. although the numbers are smaller,ranging between a low of 131 in 1983 to a high of 545 in 1989, and the fluctuations less dramatic(Figure 8). Increases in the number of vacancies in all four (region and size) groupings contrlbuted tothe 1981 peak, while the slow rise from 1983 to 1987 appears to have been related to a matching221400Figure 7Number of ill Claimants! versus Number of DTF Vacanciesfor RNs, 1986 ·1991600~1300..~ 12008:soS 1100'Cl~ 1000Z900_........ - ... - ..... -- .....,,illClaimants.., ,,'. RN" Vacancies500400~cB.;300 8'C2001:z::100800 I I I I I I I I I I I i I 0Mar-86 Sep-86 Mar-87 Scp-87 Mar-88 Sep-88 Mar-89 Sep-89 Mar-90 Sep-90 Fe~91 Sept-91QuarterI Number of Claimants refers to Regular Claimants (see explanation in text). Data are available for 1986 to 1991 only. Source: Regional EconomicServices Branch for British Columbia & Yukon, Employment and Immigration (JtnadaFigureSDTF Vacancies for Other Disciplinesby Region and Size of Facility, 1980 • 1991160014001200GVRHD<400- --. -.-'--- -- ---:....... - --• -s, - :: ~ - -.. ..GVRHD400+All B.C.OtherB.t.1<400-- -- -~ -..~ -------.......- ,-""" .... - ..~~LL _----- _---:::=:z:... ,. .. __~ .--- • ",- - - &:=r~ ':l .. ~ - -.. ~ =-r-~ ::::: : _~ z:» i-= ~ =-= ;-r ~200400II'tI 1000~~'0 800b1 600Z~o I I I Iii iii i I I1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991Yearincrease in the number of vacancies in the <400 becHacUities. 'The peak seen in 1989 was due to theincrease in the number of vacancies in the GVRJID400+ bed facilities.'The vacancies In the GVRHD 400+ bed facilities accounted for the largest percentage ofvacancies in 1981 and 1989-91, but foe a lesser percentage of the vacancies at other times (Figure 9).The number of vacancies in all facilities outside the GVRHD (regardless of bed capacity) accountedfor the majority of the vacancies from 1982 to 1987. lhis is very different from the picture for RNs .(Figure 3), in which the number of vacancies in the GVRHD was always greater than the numberoutside the GVRHD.B. Occupational GroupFigures lOa and lOb illustrate the number of difficult-to-fill vacancies for the seven non-RNhealth disciplines which showed the greatest problems during the study period. Physiotherapists andOccupational Therapists consistently appeared as large contributors to the total number of difficult-to­fill vacancies, accounting for a combined percentage of 48.6 in 1986 which later fell to a low of 26.5percent in 1990. Respiratory Therapists have maintained a fairly steady number of difficult-to-fillvacancies, with only minor fluctuations throughout the period 1980 to 1991, and slight peaks in 1981and 1989, in keeping with the trend seen amoung Registered Nurses and other health occupations.Physicians had no DTF vacancies during the first four years of the study, but have increasedoverall since then, with some fluctuations from year to year. The number of DTF vacancies forSecretarial/Clerical positions peaked in 1981 and again in 1989, following a trend slmllar to the overallvacancy picture for all disciplines (other than RNs). The vacancies for Pharmacists have beensomewhat similar to th~e for Physicians, in that they reported very few DTF vacancies from 1980 to1983 with an increase in number from 1983 to 1987 and a slight dip in 1986. However. thePharmacist vacancies have been fairly constant since 1988, while Physician D'IF positions showed apeak in 1990. LPNs/Orderlies showed a large increase in the number of D'IF vacancies in 1981. and25~100%90%80%70%Ii'tIr:l 60%"~ SOIJ....0...~ 401J.It3Q1J.20%10%0%Figure 9Percentage Distribution ofDTF Vaamcies for Other Disciplinesby Region and Size of Facilityt 1980 - 19911980 1981 1982 1983 1984 1985Year1986 1987 1988 1989 1990 1991I_ GVRHD 400+ l1li GVRHD <400 IIID Other B.C.400+ 0 OtherB.C.<400 IFigure lOaDTF Vacandes for Other DlsdpHnesby DiscIpline, 1980 - 19911991199019891988- - -Physiotbempists1987- .... - .OccupationalThempists19861985-------1984 '1983........................- - - -- ...... ......... 0 .."",,'- - - -...... ............ ...~i'1I'81OIY- - - - - - -./ ......... Thempists-- ,<,19821981---- -200180160140~'tI~ I I:l 120!!~-0 100tl.0~ 80Z60402001980Year\Figure lObDTF Vacandes for Other Dtsdpll.oesby DIsdpline, 1980 - 1991Pharmacists19911990\ '.\ ,,' '" Physicians. ,x """,," '" -." ''" ......"'"<,<, Secretarlall<, ClerlcA,,., "1989///1988..... ,1987~" ... (, ./ '....-- ~#!-- - »: ..... .:', ,'".. ~, .....19861985198419831982LPNs/Orderlies200180160140t1~ I i 120CIl:: 1000I 80:z.60402001980 1981Yearmuch smaller peaks in 1986 and 1989w1990.Comparing the DTF vacancies for LPNS/Orderlies to those for RNs and also Nurses' Aides(NAs), the peak in 1981 was greatest for LPNs/Orderlies and RNs and lesser for NAs (Figure 11).The three groups differ significantly after 1982 in the distributionof their dlfficult-to-flll vacancies,suggesting that little relationship exists between the vacancies of the three groups, although it shouldbe noted that the number of DTF vacancies for NAs seems somewhat inversely related to that forLPNs/Order1les after 1982.C. Vacancy Rates per 100 BedsFigure 12 illustrates the vacancy rates per 100 approved beds for disciplines other thanRNs byregion and size. All four region/size groups followed the same trend closely from 1980 to 1984,peaking in 1981. However, from 1985 onward, the trends in the vacancy rate per 100 beds for theregion/size groups appear to differ greatly. Closer examinationreveals that each region/size group infact peaks. although in different years. The first peak belongs to the Other B.C. 400+ bed facilities in1986, followed by the GVRHD <400 bed facilities and the Other B.C. <400 bed facilities in 1987, andthen the GVRHD 400+ bed facilities in 1989.Since we have no control over the types of positions reported to us in this category (disciplinesother than RNs). Le. we did not survey about specific DlF vacancies such as Physiotherapists orLPNs, the positions reported can vary greatly from one quarterly report to the next. For this reason itis difficult to make useful comparisons across time and no conclusions can be drawn about whichyears were the best and which were the worst. The total number of vacancies for Other Disciplines isbased on which hospitals are experiencing problems at a particular time, and for which' among themany disciplines. For example, in Figure 130. the large peaks in the va.caney rate per 100 beds forPhysiotherapists in 1986 and 1987 probably contributed greatly to the peaks in overall vacancy rates of1986 and 1987 that were seen for facilities with <400 beds. In 1989. peaks in the vacancy rates per29Figure 11Number of DTF Vacancies for RNs,LPNS/Orderlies, and Nunes'Aides,1980 ~ 19914001~20014001200------..-- - - - ...... - ..LPNs/Orderlies--- -- -'" ". ...- .... - .. - ..------NAs-- --2040160140120~ ..-.....1000 ~I~ z 100~ 81 !u~ rl800 J.... = 80c~"0 ....e1~ so soo I;z;~d ~1980 1981 1982 1983 1984 1985 1996 1987 '1988 1989 1990 1991YearFigureUDTF Vacancies for Other DIsclplines per 100 Approved Beds,by Region and Size of Facillty, 1980 • 19915,""""""'-- _ - -..,-.OtberB.C.<400<,'"GVRHD I,<400 ' ,, '/\ 1 "/ \ " ,GVRHD/ '/ \ I' 400+/ ,'\ '~/ , ' \ I ', ' ,,'". --'•\ 'I • " • -- --. ' . ~ ,....-\ ' , ' " ,-- .\ " I' ,',f ' 1 .......... ' '., _.' 1 - _.' 1 '\' ' - __ ' I - ' •-.., , ,.....' .»" \ ' ' f / ,,' ,, • \..' Othe, .r: _-... ' \, . 1 • • • <, : r B.C. -,,., . _ • \. • 1 / ~ 400+ ".-- '\ . . .... . " - ..'' . ' . ...... . .,. . . ~... - . .. -' . /" \ -"'~ .' ' . ,.., '.'" ....- '. -" ""'-,,~- -:' /' / " .. ,. --_ ..,"/" "./, ' /'= ~ - . ../ /,'-. ......... _" ...... --"".. ..1 -4 .0545i 3.5§l 31.l~ 2.5>.~ 2.;~ 1.5QlMI-l19911990198919881986198519841983• I19821981o I I I I I I I I I I I1980YearW~0.90.8i 0.7~g 0.6,...(lO.5~CIlIll:t' 0.4aCIl~ 0.3~l=l 020.1oFigure 13aDTF Vacandes for OtherDisclplInes per 100Approved Beds,by Discipline for Three Problem Areas, 1980 - 19911980 1981 1982 1983 1984 1985Year1986 1987 1988 1989 1990 1991I_ Physiotherapists 0 Occupational Therapists I11III Respiatory Tbecapists I~~090.8<II 0.7if~:5 0.6.-(lO.5$~~OAa-:. 03~Q 0.20.1o I 1"""1Figure 13bDTF Vaamcles for OtherDisciplines per 100 Approved Beds,by Discipline for 'Three ProblemAreas, 1980 . 19911980 1981 1982 1983 1984 1985Year1986 1987 1988 1989 1990 1991I- Physicians D Secretaria1lClerk III LPNs/Orderlies I100 beds for Occupational Therapists and SecretarlaI/Clerlcal (Figures 13a and 13b) probablycontributed to the peak in the vacancy rate for the GVRlID 400+ bed fadlltles, but they werenot theonly factors , Figures 13a and 13b on vacancy rates per 100 beds follow the trends seen in the numberof DTF vacancies in Figures loa and lOb very closely. However, it is clear that vacancy rates per 100beds for other personnel follow the trend seen among RNs only for selected years.D. Vacancy Rates per 100 Employed PersonnelTable 4 examines the difticult-to-fill vacancies per 100 employed or active/practising personnelfor selected disciplines. The Health Human Resources Unit (HHRU) publishes data on the number ofpersonnel in various health-related disciplines in British Columbia, but many of the databases areextracted from membership lists of the various associations and governing bodies and membership isoften not mandatory. 'The disciplines included in this table are therefore limited to those included inthe DTF surveys and for whom adequate data exist in the way of membership lists with compulsoryregistration.The largest group included in Table 4 Is the Physicians', for whom the vacancy rate (per 100non-postgraduate directory active physicians) ranged from 0 to 1.27 during the study period, and thetotal number of physicians increased from 5,037 to 6,919. From 1984 to 1987 the number ofphysicians in the GVRlID accounted for between 54.7 and 56.0 percent of all physicians in theprovince, and the vacancy rate in the GVRHD was smaller than that outside the GVRHD. From 1988to 1991, the percentage of physicians in the GVRlID increased slightly, to range between 56.4 and58.0 percent Despite this increase, the vacancy rate also increased in the GVRHD compared to theprevious period. due to large increases in the number of vacancies reported for physicians during thoseyears. Meanwhile. the vacancy rate outside the GVRHD increased from 1984 to 1988, and thendropped sharply in 1989 to level off until 1991.The vacancy rate per 100 employed LPNs was greater outside the GVRHD for most of the34Table 4Difficult-ro-Fill Vacancies per 100 Employed Personnel',for Selected Disciplines, by Region, 1980 • 1991Discipline Regioo 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991192LPNs 2 GVRHD 0.76 1.82 0.26 0.13 0.00 0.00 0.58 0.00 0.26 0.08 0.15 0.45OtherB.C. 0.36 2.61 0.76 0.18 0.47 0.51 0.85 0.62 0.50 0.87 0.79 0.00Total 0.50 2.33 0.58 0.16 0.31 0.34 0.76 0.41 0.42 0.61 0.57 0.16Pbar.macists 1 GVRHD 2.80 1.61 0.00 0.00 1.90 8.11 1.72 7.62 1.24- 2.22 1.87 3.66OtherB.C. 2.38 3.13 4.90 0.00 7.'12 5.26 8.65 14.29 10.00 5.88 6.00 5.52Total 2.62 2.27 2.08 0.00 3.92 6.87 4.32 10.03 4.31 3.45 3.36 4.36Physicians 4 GVRHD 0.00 0.00 0.00 0.00 0.00 0.15 0.36 0.06 0.99 0.67 1.92 0.91OtherB.C. 0.00 0.00 0.00 0.00 0.19 0.34 0.50 0.86 0.73 0.41 0.39 0.37Total 0.00 0.00 0.00 0.00 0.09 02A 0.42 0041 0.88 0.56 127 0.68Physiotherapists 5 GVRHD - 12.63 - 3.10 - 8.65 - 22.04 - 10.80 7Jf1 5.20t..ltit OtherB.C. - 16.07 - 9.09 - 33.60 - 37.99 - 16.98 9.62 11.97Total - 14.31 - 6.13 - 19.68 - 29.56 - 13.70 8.68 8.20I Source: ROll.CAlL 81,83.85,87.89,91 and. ROlLCAll. UPDATE SO, 82, 84, 86, 88, 90. StatnsReports of SelectedHealthPersonnel in theProvince of British Columbia, HealthHumanResourcesUnit,UBC.:I LPNs employed in acutecare, activatioolrebabllitation, extendedcare, psychiatricfacilities. andcommunity health agencies, in Septemberof each of the years 1980 to 1991.:J Pharmacists employed in hospitalpbarmacles. in September of each of the yeat1 1980to 1986,and in December of eachof the years 1987to 1991.4 All Directory-Active Non-Postgraduare Physicians, in Septemberof each of theyean 1980to 1990,and in January of 1992.5 Physiotherapisls employed in acute care,children's. extended care,psychiatric. andrebabilitatioo facilities, WotXer's Compensation Board,communitybea1th centres,anddiagnostic & treatmentcentres, in October 1981.November 1983,February of 1986and 1988,andDecember of each of the yean 1989to 1991. Data not available foe 1980. 1982, 1984. 1986,and 1988.study period. the exceptions being 1980 and 1991 (Table 4). The large vacancy rate seen in 1981results from the large numberof D'IF vacancles for LPNs at that time and not the small size of theworkforce. In fact, the number of LPNs employed in the province has decreased from 4,373 in 1980to 3.828 in 1991, although there have been many fluctuations during the study period.While the number of Physiotherapists employed outside the GVRHD was only somewhatsmaller than the number employed in the GVRHD, the vacancy rate per 100 employed personneloutside the GVRHD was far greater than the vacancy rate in the GVRHD (Table4). Faclllties outsidethe GVRHD therefore appear to have bad much greater difficulties In fllllng physiotherapy positionsthan facilities in the GVRHD. The peak in the vacancy rate in 1987 for Physiotherapists coincidedwith the peak in the number of vacancies for Physiotherapists in that year.Pharmacists were the smallestgroup and bad few vacancies between 1980 and 1983,which isreflected in the relatively low vacancy rates per 100 pharmacists employed in hospitals. From 1984onward, there have been more DTF vacancies reported for pharmacists, and the vacancy rate is slightlyhigher throughout this period.E. Unemployment Insurance Clalmant StatlsticsFigure 14 illustrates the me statistics on number of regular claimants for five of thedisciplines discussed previously. Four of the disciplines show small fluctuations over the six-yearperiod but no relativechange over time. Only Pharmacists show a definite change in the number ofUl claimants, with an increase ocurring from 1986 to 1991. The number of DTF vacancies forpharmacists (Figure 1~) peaked slightly in 1987, but remained fairly constant after that time. so theincreased numbers of pharmacists looking for work apparently bad no impact on the difficult-to-fillvacancies in the hospitals.The UI claimants for the two nursing-related disciplines, Nurses' Aides andLPNS/Orderlies,are shown in Figure 15. 'There has been little variation since 1986. TIle small changes that ocurred In36Figure 14Number of UI Claimants' for Other Disciplines,1986 ~ 1991<»:Pharmacists.,. ,~/ ',/PhysiotherapistsIv--, .. -----I " .//'/'- - '""""-'''-~'\/'/...--/ <."/' f"......-./ <, / ,," /---~ <:> " <, '---....../ ~/'.---' / <, <,~. - .: --.---." I - I_ • • ._ • v - ~./ -••• _">'-. • .....'. ~~ '-/<, ' 0a:up0ti0naI""'" ",,'" ,,_._.'" Th ...- - -..... -,....,.." ' erap1SllI.. - :~ ", .,- " ..- - ~ ", ....- .-........ ' .. ' ...--. . ..j,/. ....-RespiratoryTherapists807060..11~ 50t..l I u....:a S 40'a r-"i 30:z;2010Scpl-91Feb-91Sep-9OMar-90Sep-89Sep-88 Mar-89QuarterMar-88Sep-87Mar-87Scp-86o I I j I I I I , ii, IMar·86I Number of Claimants refers to Regular Claimants (see explanation in text). Data are available for 1986 to 1991 only. Source: Regional EcooomicServices Branch for British Columbia & Yukon. Employment and Immigration CanadaFigure 15Number of ill Claimants! for Nursing-related Disciplines,1986-19911400- --1--- - -- ...- .--- .------- -~ .-._ -----~' -~------~~Nurses' AidesLPNs/Orderlies~ee1200.. 1000~8] 800US....o 600Iz 400.­1---------./""" -- - ""-" ;--, - "'- _ ./ <,--------_ ./»<;-e.200Sept-91Feb-91Sep-9OMar-90Sep-B9Sep-88 Mar-B9QuarterMar-88Sep-87Sep-86o I Iii iii I I • f iMar-86I Number of Claimants refers to Regular Claimants (see explanation in text). Dataare available for 1986 to 1991 only. Source: Regional EconomicServices Branch for British Columbia & Yukon. Employment and Immigration Canada- the number of DlF vacancies for these two disciplines during that time (Figure 11) do not thereforeseem to be related to the unemployment situation.v. SUMMARY AND DISCUSSIONDuring the study period of 1980 to 1991, we have been able to report remarkable fluctuationsin the net demand for health personnel, as measuredby the number of Difflcult-tn-Flll vacanciesreported in the province Of British Columbia Demand has fluctuated in all regions of the provinceand also in all sizes of facilities. The two periods of greatest demand occurred in 1981 and 1989.The number of Difficu1t-to-Flll (DTF) vacancies for Registered Nurses tended to be greaterthan the number of DW vacancies for all the other disciplines included in the study, with theexception of the years 1985 and 1991. Facilities in the Greater Vancouver Regional Hospital District(GVRHD), especially those with 400+ beds. experienced the greatest DW vacancy problems withRegistered Nurses. Facilities in the remainder of the province, especially the smaller size :faclllties«400 beds). experienced the greatest problems with DW vacancies for disciplines other than RNs.The nursing areas of General nursing, Medicine/Surgery, ICU/CCUJP~ GeriatricsIECU. andPsychiatry experienced the largest numbers of D'IF vacancies. The disciplines other than RNs withthe greatest DTF problems were: Physiotherapists, Occupational Therapists. Respiratory Therapists,Physicians, LPNS/Orderlies, and SecretarieslClerks.Vacancy rate calculations using the number of DW positions as the numerator and the numberof approved hospital beds in the comparable responding facilities as the denominator showed the sametrends as the raw numbers of DTF vacancies, for both the Registered Nurses and the Other Disciplines.For example, with RNs the vacancy rate peaked in 1981 and 1989, and the rate in the GVRlID 400+bed :facilities was consistently greater than the provincial rate, while the vacancy rate outside theGVRlID was always less than the provincial rate. The vacancy rates per 100 beds for differentnursing service areas closely followed the trends seen in the absolute numbers of D'IF vacancies for39the same nursing areas. The changes in the number of beds in the responding facilities thus appear tohave had no impact on the trends seen in the reported DTF vacancies. For disciplines other than RNs,there was a peak in 1981 in the vacancy rate per 100 beds for an four region and size groups. but onlythe rate in the GVRHD 400+ bed faclllties peaked in 1989. The rate in the OtherB.C. 400+ bedfacilities peaked instead in 1986. and the rates in the GVRHD and Other B.C. <400 bed facilities bothpeaked in 1987. The variation in timing of the peaks in the vacancy rates per 100 beds for disciplinesother than RNs are due to the fluctuations in the personnel category and number of DTF vacanciesreported at a particular time. For example, the large DTF vacancy rate for disciplines other than RNswhich occured in 1986 and 1987 is due to the large number of DTF vacancies for Physiotherapistsreported in those years, especially in the <400 bed facilities.Vacancy rates calculated using the number of employed personnel as a denominator showedtrends similar to the trends for the absolute numbers of DTF vacancies and the vacancy rates per 100beds for RNs. The vacancy rate per 100 practising RNs in the GVR1ID was always greater than theprovincial vacancy rate. and the vacancy rate outside the GVRHD was always less than the provincialrate. General nursing. Psychiatry, Medicine/Surgery and GeriatricsIECU again appeared as the majorcontributions to the overall vacancy rate.The vacancy rates per 100 employed personnel for the disciplines other than RNs were usuallygreater outside the GVRHD than in the GVRHD. This is consistent with the trend seen in the absolutenumbers of DTF vacancies for disciplines other than RNs. Using Physiotherapists again as anexample, the vacancy rate per 100 employed personnel peaked in 1987. as the number of DlFvacancies and the rate per 100 beds for Physiotherapists bad.Efforts to compare the DTF vacancies for Registered Nurses to me statistics on nursesprovided counterintuitive results for one period. as both the number of DTF vacancies and the numberof UI claimants increased from September 1988 to September 1990. when one might have expected aninverse relationship between the two statistics. An inverse relationship did appear to exist between the40number of DTF vacancies and the number of ill claimants from March 1986 till June 1988, and fromDecember 1990 unitl December 1991. It is possible that the nurses looking for work may not havebeen qualified for the reported vacant positions, but such data are not currently available. Thenumbers of ill claimants for the other disciplines stayed fairly constant between 1986 and 1991, theexception being Pharmacists who showed an increase in the number of ill claimants during thisperiod.The Difficult-to-Fill surveys and the quarterly reports based on the surveys only documentD1F vacancies and do not explain why they happen. In this report, we examined some of thepotential underlying causes for fluctuations in DTF vacancies such as changes In bed capacity, changesin the number of employed personnel. and changes in the number of unemployed (and looking forwork) individuals. in an effort to possibly explain the reason(s). The trends which were seen in thenumber of DlF vacancies reported. remained consistent when examined per 100 beds or per 100employed personnel. indicating that fluctuations and changes in bed capacity andIor number ofemployed personnel did not directly affect the'DTF vacancies. ill claimant statistics also did notprove very helpful in explaining the fluctuations seen in the D1F vacancies. However, potentialchanges in the type andIor amount of funding to facilities by the Ministry of Health. which may haveoccurred due to the 1981/82 and 1989190 funding policies, coincided with the two dramatlc decreasesin the DTF vacancies reported at those times, suggesting that th.is happened in reaction; fundinguncertainties. therefore. could be an important factor In DTF vacancy fluctuations.41! ! ,; ,REFERENCESBarer, ML., Stark, AJ., and Kinnls, C., "Manpower Planning, Fiscal Restraint. and the 'Demand' forHealth Personnel", Inquiry, Vol. 21, No.3, Fall 1984.Haazen, D.S., "Redefining the Globe: Recent Changes In the Financing of British ColumbiaHospitals", in Restructuring Canada's Health Services System: How Do We Get There From Here?,Rafsa B. Deber and Gail G. Thompson (eds.). Toronto: University of Toronto Press. 1992.Health Human Resources Unit (HHRU), ROllCAIL: A Status Report of Health Personnel in theProvince of British Columbia, UBC Centre for Health Services and Policy Research, 1981, 1983,1985, 1987, 1989. and 1991.Health Human Resources Unit (HHRU), ROLLCAIL UPDATE: A Status Report of Selected HealthPersonnel in the Province of British Columbia. UBC Centre for Health Services and Policy Research,1980, 1982, 1984. 1986, 1988. and 1990.Klnnls, C., Dlfficult1O:Fill Vacancies in the Health Care Field. British Columbia, 1980 - 1986. HHRU87:4, UBC Centre for Health Services and Pollcy Research. June 1987.43APPENDIX AMAP OF REGIONAL HOSPITAL DISTRICTSi- ,i -~A~BIDlU JI-rth~IOvaHD) Caplllll1 Pno5cr V&Iky4 Ob.aapn5 Soatll-EMt'bImd Coast7 O:ntnll• North O:ntnll, North ."'RqIlmal Jbpflal DiIaiI:Is Imft bcaIIItJtlnlDy pDIIplld llJ l!IG~~~ u-. UJL.C. ill ... IDprvvIde...... time b IIIIa!J* ~-oa­pnmudpuap..27 3023Regional Hospital District1 ~~23 ~4iii C=tn1e:-t6 ~ Prue3:Vll1ky7 C=traI~8 ~O~I=1D11 Cawichan VIIlk:y12 ~~13.'4 poscr-a.c.m15 Pzuc:r-PartGemJl'16 ("rrcm:rV~17 1Clt!mlol..stltiDc,. ~;;!t2r.;:,.m Nmaimo%t=?-'",2223 Peace •24 PooodI Rivu25 Sl=Da-O""ClI Olarloac26~'ZT28 SunddDe ee.t29~304Source: Population Section, PI~ andStatisticsDMsion. MF&CR.APPENDIXBNUMBER OF DIFFICULT-TO-FILL VACANCIESFOR REGISTERED NURSES, 1980 - 1991AppendixBNumber of DifficuIt-to-EilI Vacancies for Registered Nurses,1980 -1991By Region and Size of FacilityYearReglonlSlzeGroups 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991GVRHD 400 717 2A7 195 260 164 471 566 82A 1166 826 254OtherB.C. 250 266 60 39 81 74 197 174 314 42A 175 68All 400+ Beds 339 745 221 159 216 154 391 447 689 1094 739 227All <400 Beds 311 238 86 75 125 84 277 293 449 496 262 95GVRHD 400+Beds 269 646 196 138 208 122 318 361 573 860 659 189GVRHD <400 Beds 131 71 51 57 52 42 153 205 251 306 167 65Other BC 400+ Beds 70 99 25 21 8 32 73 86 116 234- 80 38Other BC <400 Beds ISO 167 35 18 73 42 12A 88 198 190 95 30Total B.C. 650 983 307 234 341 238 668 740 1138 1590 1001 322By Nursing AreaYearNursing Area 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991General 155 181 64 55 54 30 140 75 ISO 330 149 20Medicine 112 184 43 7 9 20 37 60 90 137 45 2Surgery 59 173 55 6 8 8 28 39 62 113 55 5Paediatrics 14 11 3 2 8 11 95 98 101 81 39 10Obstetrics 18 31 17 40 9 13 5 16 26 67 19 5lCU/CCUIPAR 83 123 40 66 159 66 224 311 263 331 2A3 66Psychiatry 36 156 35 4 6 6 13 10 231 203 110 121ECU/Geriatrics 69 36 12 4 33 16 48 50 67 135 146 30OR 51 37 9 5 25 23 19 15 31 42 32 10Administration 9 10 3 5 12 13 9 2 6 31 5 6Rehabilitation 26 13 4 3 3 3 6 11 21 21 23 5Spinal 5 2 3 0 0 1 5 6 11 2 9 1CardioJI'homcic 0 3 15 31 0 1 2 8 0 0 0 0Emergency 6 15 3 3 10 9 12 14 34 68 76 35Miscellaneous 7 8 1 3 5 18 25 25 15 29 16 6Card. Surg.ffranspl. 0 0 0 0 0 0 0 0 0 0 34 0Total 650 983 307 234 341 238 668 740 1138 1590 1001 32251IAPPENDIX CNUMBER OF DIFFICULT·TO-FILL VACANCIESFOR OTHER DISCIPLINES, 1980 -1991Appendix CNumber of Difficult-to-FiI1 Vacancies for Other Disciplines,1980 -1991By Region and Size of FacilityYearRegtonlSluGroups 1980 1981 1982 1983 1984 1985 1986 1981 1988 1989 1990 1991GVRIID 174 243 68 52 78 143' 207 231 263 362 319 265OtberB.C. 136 221 94 79 172 181 279 272 184 183 171 133A1l400+ Beds 126 236 92 53 99 157 212 161 163 313 284 184A1l <400 Beds 184 228 70 78 151 167 274 342 284 232 206 214GVRHD 400+ Beds 86 133 38 26 38 89 110 84 133 248 198 137GVRHD <400 Beds 88 110 30 26 40 54 97 147 130 114 121 128OtherBC400+ Beds 40 103 54 27 61 68 102 77 30 65 86 47OtherBC<400Beds 96 118 40 52 111 113 177 195 154 118 85 86TotaJB.C. 310 464 162 131 250 324 486 503 447 545 490 398By Disclpllne!YearDlsdpUne 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991LPNs/Orderlies 22 105 25 7 12 13 31 15 15 23 22 6Nurses'Aides 1 7 1 4 2 1 0 5 11 ' 4 7 4Occupational Therapists 61 61 22 26 43 44 65 67 61 83 66 52Pharmacists 5 5 5 0 10 18 12 35 16 14 14 19Physicians 0 0 0 0 5 14 25 25 55 36 !.5 47Physiotherapists 52 82 23 32 60 110 171 175 126 93 64 65RespiratoryTherapists 12 24 15 20 25 26 34 32 20 44 27 7Secretarial/Clerlcal 10 30 12 2 8 6 25 38 44 94 49 25I Only the selected disciplines thatwere discussed in the text are listed. The numberof D1F vacancies for otherdisciplines not listed are available from the Health Human Resources Unit.55APPENDIXDAPPROVED BED CAPACITY FOR DTF FACILITIES,BY SIZE AND REGION OF FACILITY, 1980 - 1991AppendixDApproved Bed Capacity- for DTF Facilities,by Size and Region of Facility, 1980·1991YearReglonlSlnGroups 1980 1981 1982 1983 1984 l.985 1986 1987 1988 1989 1990 1991GVRHD 9642 10168 10187 9414 9396 9831 10005 10015 10146 10555 10590 10321OtberB.C. 10449 10546 10606 10385 10474 10617 10710 10864 11030 10843 10890 10894All 400+ Beds 9662 10477 10463 9154 9103 9902 10080 10450 10566 10619 11120 10866All <400Beds 10429 10237 10330 10645 10767 10546 10635 10429 10610 10779 10360 10349u. GVRHD 4QO+. Beds 6466 7191 7W5 6448 6430 6807 6956 6882 6907 6895 7005 6767ICGVRHD <400Beds 3176 2977 2982 2966 2966 3024 3049 3133 3239 3660 3585 3554OtherBC 400+ Beds 3196 3286 3258 2706 2673 3095 3124 3568 3659 3724 4115 4099Other: BC <400Beds 7253 7260 7348 7679 7801 7522 7586 7196 7371 7119 6175 6795Total B.C. 20091 20714 20793 19799 19870 20448 20715 20879 21176 21398 21480 21215I Numberof approvedbeds as listed by the HospitalCare division of tile B.C. Mi.nistty of Health. for March 31 of each year.APPENDIXENUMBER OF PRACTISING REGISTERED NURSESEMPLOYED IN THE STUDY FACILITIES,BY NURSING AREA AND REGION OF FACILITY, 1980 - 1991Appendix ENumber of Practising Registered Nurses Employed in the Study Faclllties',by Nursing Area and Region of Facility, 1980 -1991YearNursing Area Region 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991General Z GVRHD - - - - 130 149 141 151 143 137 122 114Other B.C. - . -- 527 550 543 525 542 533 536 539Med1Surg 3 GVRlID 3113 3503 3307 2902 3759 3980 4112 4264- 4331 4482 4766 4987OlhuB.C. 2647 2951 2677 2194 2699 1%19 2859 3006 2959 3190 3124 3343Psychiatry GVRlID 170 193 249 238 282 296 319 312 309 327 319 352Other B.C. 2Zl 239 212 180 214 229 '137 229 217 222 249 262Paediatrics GVRHD 308 330 319 293 358 395 412 443 424 434 457 460Other B.C. 237 261 2AO 180 281 284 257 249 239 248 257- 254Obstetrics GVRHD 472 533 518 458 593 626 592 604 597 640 680 728OlhuB.C. 468 506 499 422 571 578 550 555 554 566 553 587e GeriatricsIECU GVRHD 317 407 367 327 443 477 557 553 580 584 650 666Other B.C. 388 482 400 331 481 521 549 551 547 587 564 578Administration GVRHD 110 144 163 75 283 338 340 341 355 363 365 364OtberB.C. 172 204 192 400 293 307 298 307 330 315 321 338Olher 4 GVRHD 556 530 442 452 122 133 133 160 338 410 491 559Other B.C. 711 788 f/n 321 52 61 72 79 160 210 251 280Total GVlUID 5046 5641 5364 4744 5970 6394 66(J7 6827 7076 7378 7849 8231OtberB.C. 4849 5431 4918 4029 5119 5410 5366 5501 5549 5872 5856 6183TotBl B.C. 9895 11072 10282 ern 11090 11804 11972 12328 12625 13250 13705 14414I Includes only data on RNs (see text), from RNABCregistration datafor practisingRNs employed in the study facilitieson a full-time or part-time bam(excludingcasual). in June of each of the years 1980 to 1991.2 Includes the DlF category of General;andthe RNABC categories of General Practice, and'Several Areas' (includesfloat, smallhospital, andcommunity).The RNABC ca.legories of General Practice andSeveral Areas didnotexist between 1980 and1983.) Includes the DTF categoriesof Medicine. Surgery,lCUICCUIP~ OR. Emergency.Spinal, Cardio-tboracic, andCardiac Surgery & TransplantIncludes the RNABC categories of MedicinflSurgery. MedicinelSurgery Specialties, CriticalCare. OR, PAR,andEmergency.4 Includes the D1F categoriesof Rehabilitation andMiscellaneous. Includes theRNABC categories of OccupationalHealth. Research. Teaching(all categories). and Other Patient Care. The RNABC categories of unspecified 'Direct Patient Care' and'Unknown' were distributed proportiooaIlyamong the other categories.APPENDIX FNUMBER OF EMPLOYED PERSONNELFOR SELECTED DISCIPLINES, BY REGION, 1980 - 1991AppendixFNumber of Employed Personnel! for Selected Disciplines,by Region, 1980·1991Yeal"Di:sclpUne Region 1980 1981 1982 1983 1.984 1985 1986 1987 1988 1989 1990 1991J92LPNs! GVRlID 1575 1591 1540 1489 1357 1268 1389 1251 1166 1221 1310 1320Other B.C. 2798 2916 2763 2764 2570 2563 2694 2430 2396 2521 2530 2508Tora! 4373 4507 4303 4253 3927 3831 4083 3681 3562 3742 3&40 3828Pharmacists 3 GVRHD 107 124 138 146 158 148 174 223 241 270 267 273Other B.C. 84 96 102 104 97 114 104 126 130 136 150 163Total 191 220 240 2SO 255 262 278 349 371 4{)6 417 436Physicians 4 GVRHD 2736 2859 2930 3043 3107 3275 3327 3404 3523 3746 3849 3964Other B.C. 2301 2377 2450 2504 2569 2611 2626 2673 2722 2713 2821 2955Tora! 5037 5236 5380 5547 5676 5886 5953 6077 6245 6459 6670 6919~ Pbysiothernpists s GVRBD - 293 - 258-312-313-361 394 442OtberB.C. - 280 - 264 - 247 - 279 - 318 343 351Tora! - 573 - 522 - 559 - 592 - 679 737 793I Source: ROLLCALL81,83.85. F;7, 89.91 and ROILCALL UPDATE 80, 82, 84. 86, 88.90. StatusReports of SelectedHealth Personnel in theProvinceof British Columbia.Health HumanResources Unit. UBC.I LPNs employed in acute care. activationlrebabilitation,extended care, psychiatricfacilities, and communityhealth agencies. in Septemberof eachof the years 1980 to 1991.3 Pharmacists employed in hospital pharmacies, in September of each of the years 1980 to 1986. and in Decemberof each of the years 1987 to 1991.4 All Directory-ActiveNon-PostgraduatePbysicians. in Septemberof each of theyean 1980to 1990, and in January of 1992.S Physiotherapists employed in acute care. children's, extended care, psychiatric.and rehabilitationfacilities, Worker's Compensation Board,communityhealth centres. and diagnostic & treatment centres, in October 1981,November 1983,February of 1986 and 1988, andDecember of each of the years 1989 to 1991. Data not available for 1980.1982. 1984, 1986,and 1988.'-,HHRU85:1(R:25)HHRU85:2(S:18)HHRU85:3(R:26)HHRU85:4(R:27)HHRU 85:5(5:19)HHRU85:6(HMRU 85:1)HHRU86:1(HMRU 86:1)HHRU86:2(S:20)HHRU86:3(It28)HHRU86:4(p:7)HHRU86:S(R:29)HHRU86:6(5:21)Health Human Resources UnitCentre for Health Services and Pollcy ResearchThe University ofBritish Columbia429 - 2194 Health Sciences MallVancouver, B.C. vet 1Z3Telephone: (604) 822-4810Fax: (604) 822-5690Pharmacists in British Columbia, 1975-1983. A DescriptiveReport. February1985. (C. Jackson.S. Chan. M.L. Barer)Life-CycleActivity PatternsofRegistered Nurses in British Columbia:ForecastingFuture SupplyandProfessionalLife Expectancy. March 1985. (A.Kazanjian, K. Brothers, G.Wong)ROlLCALL UPDATE84. A Status Report ofSelectedHealth Personnel inBritist: Columbia, and an Analysis ofTrends, 1974-84. April 1985.Dentists, Dental Hygienists and CertifiedDental Assistants in British Columbia,1974-1984. A DescriptiveReport. April 1985. (R. Gupta, G. Wong, M.L. Barer, AKazanjian)Tobacco Taxes and Health Care Costs: Do CanadianSmokers Pay Their Way?April 1985. (GL. Stoddart, RJ. Labelle. M.L. Barer, RO. Evans)Fee PracticeMedical ServiceExpendituresPer Capita, and Full-Time-BquivaientPhysicians in B.C 1979-80 to 1983-84. May 1985. (ML. Barer, P. Wong Fung)Diagnostic Ultrasound,in B.C.• 1979 to 1984, February 1986.(C. Kinnis. M.L. Barer)life CycleActivity Pattems ofPhysicimJs. February 1986. (M.L. Barer.R. Gupta. M. Kruger)ROlLCAlL 85. A Status Report ofHealth Personnel In the Province ofBritishColumbia. March 1986.PRODUCfION 85. A Status Report on the Production ofHealth and HumanServices Personnel in the ProvinceofBritish Columbia. March 1986.Place ofGraduation/or Selected Health Occupations, 1985. May 1986. (Y. Lee.C. Jackson)Specialty and Practice LocationDecisionsofPhysicians Entering PostgraduateTraining in British Columbia, 1974 to 1978. May 1986. (M.L. Barer, C. Kinnls, S.Chan)69HHRU 86:7(S:22)HHRU86:8(R:30)HHRU87:1(S:23)HHRU87:2(R:31)HHRU87:3(HMRU 87:1)HHRU87:4(S:24)Nurse Requirements in British Columbia: 1979-1982 Trends. Part II- NurseEducators (Academic) - PreliminaryFindings. September 1986. (A. Kazanjian, S.Chan)Registered PsychiatricNurses inBritish Columbia, 1985. A Status Report.October 1986. (C. Kinnis)Dental Hygienists in British Columbia, 1985: A SUTVey ofDemographic,Educationaland Career Patterns. February 1987. (I. Pulcins, V. Lee)ROILCALL UPDATE86. A Status Report ofSelected Health Personnel in theProvinceofBritish Columbia. March 1987.Fee PracticeMedical Service Expenditures per Capita, and Full-Time-EquivalentPhysicians in B.C., 1985-86. March 1987. (M.L. Barer, P. Wong Fung)Difficult-to-Fill Vacancies in the Health Care Field, British Columbia, 198()"1986.June1987. (C. Kfnnis)llliRU 88:1(1) 'I'MNurse Manpower Study. Volume I: Report ofthe Nurse ManpowerStudy(HMRU 88:1(1» Advisory Committee. February 1988.HHRU 88:1(2) The Nurse ManpowerStudy. Volume II: A Synthesis ojthe Nurse Manpower(HMRU 88:1(2» Data in British Columbia. February 1988. (I. Pulcins, A. Kazanjian, Ie. Kerluke)HHRU 88:1(3) The Nurse Manpower Study. VolumeIII: Influenceof the Worlqilace on Nurse(HMRU 88:1(3» Manpower Suppiy in Brltish Columbia: An BxploratoryStudy, February 1988. (D.G.Layton)HHRU88:2(HMRU 88:2)HHRU88:3(HMRU 88:3)HHRU88:4(HMRU88:4)HHRU88:S(HMRU 88:5)HHRU88:6(HMRU 88:6)HHRU88:7(HMRU 88:7)HHRU89:1(HMRU 89:1)Diagnostic Ultrasound in British Columbia, 1986. March 1988. (C. Kinnls, ML.Barer)Social Workers in Health Care Settings in British Columbia, 1987. A StatusReport. March 1988. (1 Pulcins, S. Chan)ROUCAlL 87. A Status Report ofHealth Personnel ln tM Province ofBritishColumbia. March 1988.PRODUCTION87. A Status Report on the Production ojHealth andHU1tUJ1JServices Personnel in the ProvinceofBritish Columbia. March 1988.Supply ofand Requirementsfor Acathmic Medical Manpower in BritishColumbia. May 1988. (M.L. Barer, A Kazanjian, N. Pagliccia)Place ofGraduationfor SelectedHealth Occupations - 1987. August 1988. (K.Kerluke, C. Jackson, A Kazanjian)ROILCALL UPDATE88. A Status Report ofSelected Health Personnel in theProvince ofBritish Columbia. March 1988.70mmU89:2(HMRU 89:2)HHRU89:3(HMRU 89:3)mmU89:4(HMRU89:4)HHRU90:1(HMRU90:1)HHRU90:2(HMRU90:2)mmU90:3(HMRU90:3)HHRU90:4(HMRU90:4)mmU90:5(HMRU90:5)HHRU90:6(HMRU90:6)HHRU90:7(HMRU9O:7)HHRU91:1HHRU91:2llliRU91:3HHRU91:4RHealth Managers in B.C. Part 1: Methods and PreliminaryFindings FromSurvey ofChiefExecutive Officers. July 1989. CA. Kazanjian. N. Pagllcc1a, C.Jackson)Fee Practice MedicalServiceExpendituresPer Capita, and Full-Time-EquivalentPbysicians in British Columbia, 1987-88. August 1989. (A Kazanjian. P. WongFung, ML. Barer)Providers ofVuion Care in British Columbia: A Report on the Status ofOphthalmologists and Optometrists, and On tM Utilization of Ophthalmological andOptometricServices, 1975-1988. July 1989. (l Puldns, P. Wong Fung, C. Jackson,K. Kerluke, A Kazanjian)Nurse DeploymentPatterns: Examplesfor Health Human ResourcesManagement.February 1990. (A. Kazanjian.1.Pulclns, K Kerluke)ProceedingsoftM Workshop on Priorities in Health HU1IUl1I ResourcesResearchin Canada. March 1990. (A Kazanjian, K. Friesen)ROlLCAlL 89. A Status Report ofHealth Personnel in the Province ofBritishColumbia. March 1990.PRODUCTION89. A StatusReport on the ProductionofHUlIth and HumanServices Personnel in the ProvinceofBritish Columbia. March 1990.Health PersonnelModelling: A Bibliography WithAbstracts. June 1990. (N.Pagliccia, C. Jackson, A. Kazanjian)Health Managers in B.C. Part H: Who Manages Our System? ­Sociodemographic Characteristics, EmploymentPatterns; Educational BacJcgroundand Training ofHealth Managers. June 1990. (A. Kazanjian. C. Jackson, N.Pagliccia)Place ofGraduation for SelectedHealth Occupations -1989. November 1990.(S. Cavalier. K. Kerluke,L. Wood)Registered Psychologists in British Columbia, 1990: A Status Report. March 1991. (C.Jackson. L Wood. K. Keriuke, A Kazanjian)Study ofRural Physician Supply: Practice IocationDecisions and Problems inRetention. Volume I. March 1991. (A Kazanjian, N. Pagllccia, L. Apland, S. Cavalier.L Wood)ROLLCALL UPDATE90. A StatusReport ofSelected Health Personnel in theProvince ofBritish Columbia. March 1991.A Single Stochastic Model For ForecastingNurse Supply and For Estimating life­Cycle Activity Patterns. May 1991. (A Kazanjian)71HHRU 92:1 Information Needed to SupportHealthHUmLJrJ ResourcesManagement. February1992. (A Kazanjian)HHRU 92:2 ROUCALL 91. A StatusReport0/HealthPersonnel in the ProvinceofBritishColumbia. May 1992HHRU 92:3 PRODUcrlON 91. A StatusReport ont~ Production ofHealth and HumanServicesPersonnel in the Province ofBritish Columbia. May 1992.HHRU 92:4R A Human Resources Decision SupportModel: Nurse Deployment Patterns in OneCanadian System. November 1992. (A Kazanjian, I. Pulcins, K. Kerluke)HHRU 92:5R Health "Manpower" Planning or GenderRelations?The Obvious and the Oblique.Iune 1992. (A. Kazanjian)HHRU 92:6 PLACEOF GRADUATION 91. A StatusReporton PlaceofGraduation for SelectedHealth Personnel in the Province ofBritish Columbia. November 1992.(A MacDonald, K. Kerluke, L.R. Apland, L. Wood)HHRU 92:7 Fee Practice Medical Service Expenditures per Capita, and Full-Time-EquivalentPhysicians in British Columbia, 1989-1990. November 1992. (A Kazanjian,P. Wong Fung, ML. Barer)HHRU 92:8 Diagnostic MedicalSonographers in British Columbia, 1991. December 1992(LE. Apland, A. Kazanjian)HHRU 93:1 StLuly ofRuralPhysician Supply: Perceptions ofRural and Urban. January 1993. (N.Pagliccia, L.E. Apland, A. Kazanjian)HHRU 93:2 Nursing Resources Models: Part I: Synthesisofthe Literature anda ModellingStrategy/or B.C. February 1993. (N. Pagliccia, L. Wood, A Kazanjian)HHRU 93:3 NursingResourcesinBritish Columbia: Trends, Tensions andTentative Solutions.February 1993. (A Kazanjian, L. Wood) Also listed as Health Polley Research UnitReport HPRU 93:5DHHRU 93:4 ROUCALL UPDATE 92. A StatusReportofSelectedHealth Personnelin theProvinceofBritish Columbia. Aprlll993.72

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