Environmental Scan - Government of Nova Scotia

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Physician Resource PlanningAn Environmental Scanversus major procedures, inter-disciplinary trauma case protocols, level of academic activity, and quality ofbilling data.The mean actual reported neurosurgeon FTE to population ratio in Canada according to CIHI in 2004 was oneFTE per 201,000. Currently in Nova Scotia there is about one FTE per 94,000. The United Kingdom (SBBS)recommends one neurosurgeon FTE per 240,000 population 122 . Ontario studies (Wright et.al. 2003)recommend one per 150,000. Currently (2008/09 CIHI) Ontario has 1:225,000 and Alberta have 1:250,000.24.3.7 Obstetrics and GynaecologyCurrently, and in comparison to, Nova Scotia:• There are 47.6 Obstetric/Gynaecology specialist FTEs or 1.0 FTE per 19,818 population in Nova Scotia.• Benchmark(s)• The national average is 1.0 FTE per 18,394 population (Source: CIHI) or approximately 1.0 FTE per2,950 women aged 15 to 39.• A benchmark of 20,487 population per FTE was applied to the Base Case forecast in the FinalReport. The benchmark is net of adjustments for Nova Scotia birth rates, women aged 15-39, andthe higher relative obesity rate.The demands on Obstetrics and Gynaecology will vary depending on the care needs of mother and/or babyduring pregnancy and birth 123 . Demand for Obstetrics and Gynaecology care is driven by:• An increase in the number of pregnant women aged over 40 and under 20• An increase in the number of assisted conceptions, multiple births• An increase in the number of women admitted to specialist care being at 25 week of gestation or less• An increase in incidents of obesity and diabetesThe U.K. NHS 2007 Department of Health report on Gynaecology proposed that a transition towards deliveringmore gynaecology services in the community, and envisaging of the future roles of many consultantgynaecologists as leading, managing and delivering care in a community setting as part of a multi-disciplinaryteam, according to the needs of the local community. The report states that gynaecological practice is changingas there are now therapeutic options instead of major surgery for many conditions. For example hysterectomyrates for excessive menstrual bleeding have fallen since 2000 andearly termination of pregnancy and management of miscarriagecan be given as an outpatient care instead of through surgery.Nova ScotiaAnnual births are projected to decline 4% over the forecast periodfrom 8,900 to 8,500.• The provincial population of females aged 15 to 39 willdecline by 8.7% over the 10-year forecast period.• C-Section rate at 27% in 2006, national average 29%.Figure 188 Nova Scotia Population Child BearingYears, 2011-2022 (Source: DOF)122 Society of British Neurological Surgeons, Report on the British Neurosurgical Workforce Plan 2000-2015, April 2000123 U.K. NHS Centre for Workforce Intelligence, August 2010230 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
Physician Resource PlanningAn Environmental ScanFigure 189 Maternal Age by DHA of Residence, 1988-2009 (Source: Reproductive Care Provincial Program)• Percentage births ofmothers age 35+ increased to2000 and leveled since. Thoseunder age 20 declining.Figure 190 Pregnant Women >100kg 1988 to 2005 (Source: Reproductive Care Provincial Program)• BMI>30 athigher risk of congenitalabnormalities. NovaScotia prevalence ofobesity 24.3%compared to nationalaverage of 17.9%.Nova Scotia Physician SupplyFigure 191 Obstetric/Gynaecology Specialists by DHA and Population, 2009/10 (Source: MSI & PHReD)net exporter of service, probably to DHAs 7 and 9.Currently, and in comparison to, Nova Scotia:• There are 47.6 FTEobstetric/gynaecology specialists or 1.0 FTE per19,841 population. Nationally there was 1.0FTE per 18,479 in 2008/09 (source: CIHI).• There are 3,165 women aged 15-39per 1.0 FTE in Nova Scotia and 3,170 womenaged 15-39 per 1.0 FTE nationally in 2008/09.• DHAs 3, 7, and 9 are net import serviceproviders.• DHA8 has the highest femalepopulation aged 15 to 39 per 1.0 FTE and is a• 21 (35.6%) O&G specialists are age 55+ and will retire over the forecast period to 2022. In 2009-10 85%of O&G post-graduate residents in Canada are female.231 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
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3 KEY OBSERVATIONS3.1 IntroductionP
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INCIDENCEPhysician Resource Plannin
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Environmental Scan - Government of Nova Scotia

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