Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental Scanof chronic illness become more evident. This relationship between chronic illness and age is an importantvariable in forecasting future physician resource needs. A closer examination of DHA-specific populationage over the ten-year forecast period to 2021 reveals significant differences that are important inforecasting physician resource needs at a DHA and IWK level. Adjusting DHA and IWK (under age 18)population for the average provincial physician utilization rates based on five-year age cohorts has theeffect of lowering the population of Cumberland and Pictou DHAs by (15%) and (17%) respectively andincreasing the population of South Shore, Guysborough Antigonish Strait, and Cape Breton DHAs by 5%,5%, and 8% respectively. In other words, Cumberland and Pictou DHA populations are younger and SouthShore, Guysborough Antigonish Strait, and Cape Breton DHAs are older than the provincial average. Apopulation-needs based approach to physician resource planning incorporates the relationship betweenaging, chronic illness, and increased service utilization as a significant forecast model variable.Access to Services – The median wait for surgical procedures as of July 2011 varied across the province asfollows:−−−−−−General surgical procedures - is highest in the Capital and Cape Breton DHAs and lowest in theSouth Shore and Guysborough Antigonish Strait DHAs. The Capital DHA wait list at 802 is high butthe highest on a per population basis is the Cape Breton DHA.Orthopaedic surgical procedures - is highest in Capital and Cape Breton DHAs, and lowest inAnnapolis Valley DHA and IWK. The Capital DHA wait list at 3,752 is high but comparable to theother DHAs on a per population basis.Obstetric/gynaecologic – is substantially higher in the Cape Breton DHA.Urology procedures - is highest in Capital and Cape Breton DHAs.Vascular surgery - is highest in the Capital DHA. Annapolis Valley and Cape Breton DHAs arecomparable.Neurosurgery - Of the two DHAs offering neurosurgery, the median wait is highest in Cape BretonDHA and lowest in Capital DHA.Out-of-Province Patients - Out-of-Province (OOP) inpatients represent 8% of total admissions and 6% oftotal inpatient days stay at QEII and 7.5% of total admissions and 14% of total inpatient days stay at IWK. AtIWK, 20% of all patients (inpatient, outpatient, and travelling clinics) are from out-of-province. Based ondetailed MSI and shadow-bill data and supplementary IWK data on travel clinics delivered outside theprovince, it is estimated that 19% to 23% of services provided and patients seen by IWK Department ofMedicine full-time members are OOP residents. This includes services provided in New Brunswick andPrince Edward Island. New Brunswick and Prince Edward Island residents are the vast majority of OOPpatients (followed by Newfoundland and Labrador) for certain subspecialty programs, such as renaltransplantation.Nova Scotians Out-of-Province – 2.8% of physician services received by Nova Scotians were obtained outof-province.9,219 Nova Scotians received an average 5.73 services each in 2009/10 in New Brunswick.Nova Scotia - Academic MedicineMedical Education and Population Need - The Association of Faculties of Medicine of Canada hasreaffirmed that postgraduate medical education should reflect the right mix of physicians to meet societalneeds, curricula and training models must be aligned to evolving health care needs, and faculties mustprovide support to clinician-teachers through professional development.27 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011