268295 Gaps between the demand and the supply of the geriatric workforce: Analyzing the national provider identifier database

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Debra Bakerjian, PhD, RN, FNP , Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
Chin-Shang Li, PhD , Department of Public Health Sciences, University of California, Davis, Davis, CA
US Census predicts that the numbers of older adults will more than double in the next 20 years. Our ability to meet the healthcare demands of this population with more chronic illness is dependent upon adequate geriatric trained providers, yet accurately measuring the geriatric workforce (supply side) is challenging. Past methods have relied upon surveys of professional organizations and labor force statistics. Validity of these workforce estimates have been questioned because of individual inconsistencies in identifying a geriatric specialty, inherent problems of self-reported data, and lack of data from groups such as self-employed persons or those not certified but working in the industry.

The National Provider Identifier (NPI) database is a searchable, online, HIPAA compliant public registry of all provider organizations and clinicians who receive payment from Medicare and Medicaid, available since September 2007. The NPI database is likely to be more accurate than other data sources due to regulatory requirements to use NPI identifier for payment, standardized fields, and that the downloadable file contains only active data. The NPI registry provides a 10 digit unique identification number that replaces social security numbers and provides taxonomy to identify provider specialties. This registry, which is a continuously updated compilation, includes current identifier data for almost 3.5 million providers of which 2.6 million are clinicians.

Purpose: This study aims to measure the gaps between the demand and the supply of the geriatric workforce at the national and state levels analyzing the NPI dataset.

Methods: Using our original algorithm to identify geriatric clinicians, we estimate characteristics of “supply side” including (a) the number of geriatric care providers (e.g. nurses, physicians, therapists) and (b) their detailed characteristics such as gender, licensure type, location, and types of providers (e.g., individual versus group practice). These “supply side” estimates will be compared with “demand side” estimates, which were calculated based on the total population and demographic (age) compositions at the national and state level.

Expected Results: The estimated demands for geriatric providers are hypothesized to exceed the estimated supply in most states. We hypothesize great variability between states, with western states having fewer geriatric trained clinicians per capita. Policy Implications: Specific, accurate estimates of the gaps between the demand and the supply of the geriatric workforce will assist workforce planners, healthcare educators and policymakers to better meet the rapidly growing demand for geriatric care.

Learning Areas:
Program planning
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the usefulness of the National Provider Identifier database in providing measures of the geriatric workforce.

Keywords: Workforce, Nurse Practitioners

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a scientific interest in geriatric trained workforce. I was the principal investigator on a study using Centers for Medicare and Medicaid Services large data sets related to care of older adults, including data on nurse practitioners and primary care physicians.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.