RN Supply and Demand in Public Health Agencies

The Federal government has had a long-standing interest in the nursing workforce. For several decades, through its Shortage Designation Branch, HRSA has collected data on nurses in the U.S. and developed models to estimate the current and future supply of and demand for RNs. Several programs have been operating to encourage new RNs to practice in facilities with shortages of RNs, including the Nursing Education Loan Repayment Program (NELRP) and the Nursing Scholarship Program. This paper summarizes one aspect of a larger research study to develop a method for identifying facilities and communities with critical shortages of RNs in the U.S. It examines the supply, demand, and shortages of nurses in public health (PH) agencies in North Carolina (NC), using data compiled by the North Carolina Center for Nursing. The statistical models take into account population needs, practice settings, staffing levels, nursing education, and other factors related to the supply and demand for RNs. Several statistical models are summarized in this paper: 1. A pair of ordinary least squares (OLS) regression models to assess the extent to which a series of facility and county variables explain variations in the number of adverse outcomes attributed to shortages of nurses in PH agencies in NC. One model was based on data for four types of facilities (hospitals, nursing homes, home health agencies, and public health agencies), and the other was based on data for public health agencies only. 2. A pair of ordered probit models to achieve the same objective. The research revealed that: a. Of the four types of facilities used in the study, public health agencies experienced the greatest shortages of nurses, difficulty recruiting nurses, and problems related to nursing shortages. b. Several variables were related to fewer bad consequences, less difficulty recruiting nurses, and smaller shortages of nurses in public health agencies, including the presence of a nursing school, lower percentage of population 65+, higher RN salaries, and higher per capita income. c. The facility-specific data required to support these types of models are available in only a few states.