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Research and data collection play a
significant role in HHR planning. In order to determine that there will be
sufficient health professionals with the right skills to provide high quality
health care, policy makers first require sufficient data on the current supply
of health professionals. According
to CIHI, a minimum data set for measuring the supply of health professionals
includes: demographic information; education and training; geographic
distribution; migration; non-migration related attrition; employment and
practice characteristics; and productivity. Adequate
measuring of the current supply of health professionals therefore marks the
first step in HHR planning. In addition, policy makers require adequate
information on future population health needs in order to determine which types
of health professionals are needed. Research
on best practices in health care delivery is also essential for determining how
health professionals should work together to achieve the best possible
outcomes. This chapter examines current initiatives in HHR data collection and
research that serve as the basis for HHR planning across Canada.
The Committee learned that CIHI has been collecting detailed
demographic and workforce information on a broad range of health professionals,
including: physicians, nurses, occupational therapists, pharmacists, physiotherapists,
medical laboratory technologists, and medical radiation technologists. CIHI also collects aggregate data for an additional 17 health occupations,
including: chiropractors, midwives and psychologists. CIHI further noted that
its data collection facilitated national collaborative planning, as it provided
a source of interprovincial comparison in regards to workforce supply trends to
HHR planners and policy makers across the country. According to CIHI, these
data collection projects were made possible by CIHI funding received from
Health Canada’s Pan-Canadian Health Human Resource Strategy.
In its report submitted to Committee members, Canada’s Health
Care Providers, 2007, CIHI presented current demographic and
workforce trends among different categories of health professionals in Canada.
The report further indicated that there were gaps in research regarding some of
these trends, for example: the retirement profile of a variety of health
professionals; exit rates from health professions and reasons for them; and the
percentage of Aboriginal Canadians in specific health professions. Other witnesses appearing before the Committee also reinforced the fact that
there was a lack of minimum data available on Aboriginal HHR. Health Canada officials appearing before the Committee indicated that they were
working with CIHI to analyse the data available on Aboriginal HHR, as well as
work with communities to gather further information at the local level.
Witnesses further identified gaps in data collection that needed to
be addressed, including the need for CIHI and Statistics Canada to repeat the
national survey of work and health of nurses, which was considered by witnesses
to be out of date. They further noted that the survey should be expanded to include other categories
of health professionals. Other witnesses stressed the need to focus data collection not only on health professional
supply trends, but on future population health needs, such as the management of
chronic diseases as a result of the aging population. This was due to the fact that HHR planning was moving away from a model linked
to current health service utilization patterns towards the future health needs
of the population. Officials from Statistics Canada indicated that such data
was available to policy makers and planners on a cost-recovery basis through
the Canadian Community Health Survey, which collects data on the determinants
of health, health status and the utilization of health services. They indicated that it was possible to produce the data at the regional health
level, but faced difficulties in producing the data at the community level due
to reliability and confidentiality issues.
The Committee acknowledges CIHI’s efforts in expanding its data
collection initiatives to include a broad range of health professionals.
However, the Committee also recognizes that there is a need for CIHI to collect
detailed demographic and work information on all categories of health professionals,
including information gathered through survey research. Furthermore, they could
make efforts to ensure that its data remains current by repeating surveys, such
as the national survey on the work and health of nurses. Moreover, CIHI could also
work with Health Canada to examine ways of addressing gaps in HHR data
collection related to Aboriginal health human resources. Finally, the Committee
notes that there is also a need for CIHI to work with other relevant federal
government departments and agencies to collect HHR data related to the
provision of health care services and benefits to other federal client groups,
including: RCMP; immigrants and refugees; members of the Canadian Forces;
veterans; and federal inmates. The Committee therefore recommends that:
Recommendation 3:
Health Canada seriously consider providing funding through its
Pan-Canadian Health Human Resource Strategy to enable CIHI to:
- expand its data collection to include demographic and work
information on all categories of health professionals;
- repeat national HHR surveys as necessary so that they remain up
to date.
Recommendation 4:
Relevant federal government departments and agencies work closely with
CIHI to establish a minimum data set for HHR planning for all federal client
groups, including: First Nations and Inuit; RCMP; veterans; members of the
Canadian Forces; immigrants and refugees; and federal inmates.
The Committee heard from research
organizations that a significant amount of research had been conducted,
evaluating current HHR challenges, as well as various innovative pilot projects
across the country that were demonstrating positive results in addressing the
needs of health care providers. For
example, the Canadian Health Services Research Foundation (CHSRF) commissioned
a report in 2001 entitled Commitment and Care, which highlighted
successful initiatives undertaken by the British Columbia’s Ministry of Health,
which launched a program to relieve senior nurses of 20 to 30 % of patient
care in return for mentoring new, inexperienced nurses. However, despite the publication of research highlighting positive solutions to
HHR challenges, research organizations also emphasized the fact that a
mechanism is lacking in Canada to collect and disseminate this information to a
broad range of stakeholders.
In addition, witnesses appearing before the
Committee raised the issue of health research funding. They articulated that
providing sufficient funding for clinical research conducted by health care
providers would serve as a means of attracting and retaining health care
providers in Canada. Increased funding for clinical research would also serve a dual purpose in
providing further opportunities for evaluating and improving the efficiency of
Canada’s health care systems.
The Committee recognizes that there may be a
need to establish additional mechanisms for collecting and sharing research in
the area of HHR in order to move forward in promoting innovation in health
service delivery across the country, as reflected in earlier sections of this
report. The Committee also thinks that sufficient funding should be provided to
CIHR to continue supporting the clinical research of health care providers, as
a means of ensuring their recruitment and retention, as well as supporting the
overall objective of improving health care delivery. The Committee therefore
recommends that:
Recommendation 5:
The federal government seriously consider providing CIHR with
funding to develop further mechanisms aimed at supporting clinical research in
the area of HHR, recognizing it as a means of attracting and retaining health
professionals in Canada.
Recommendation 6:
The federal government continue to provide the Health Council of
Canada and CIHR with funding to determine the most appropriate mix of health professionals,
both paid and unpaid, for different communities and population groups.
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