REPORT RESUMES ED 011 555 VT 002 385 TECHNOLOGY AND MANPOWER IN THE HEALTH SERVICE INDUSTRY, 1965...75. STURM, HERMAN M. OFFICE OF MANPOWER POLICY, EVALUATION AND RES.+DOL REPORT NUMBER MANPOWER - RES-BULL -14 PUB DATE MAY 67 EDRS PR/CE MF -$0.50 HC -$4.68 115P. CESCRIPTORS OCCUPATIONAL SURVEYS, *HEALTH OCCUPATIONS, EMPLOYMENT STATISTICS, EMPLOYMENT PROJECTIONS, *TECHNOLOGICAL ADVANCEMENT, EMPLOYMENT OPPORTUNITIES, *EMPLOYMENT TRENDS, *HEALTH SERVICES, EXPENDITURES, BASED UPON PUBLISHED SOURCES AND INTERVIEWS WITH EXPERTS, THE STUDY LOOKS TOWARD PROBABLE CHANGES IN THE SIZE AND JOB CONTENT OF KEY HEALTH OCCUPATIONS TO POINT OUT PROBLEMS AND OPPORTUNITIES IN DEVELOPING PROGRAMS AND POLICIES. SOME FACTORS AFFECTING HEALTH MANPOWER ARE (1) DEVELOPMENTS IN DIAGNOSIS AND PATIENT CARE, INCLUDING AUTOMATED CLINICAL LABORATORY EQUIPMENT, IMPROVED SURGICAL TECHNIQUES AND EQUIPMENT, AND THE USE OF THE ELECTRONIC COMPUTER IN DIAGNOSIS,(2) HOSPITAL INFORMATION HANDLING, ESPECIALLY THE APPLICATION OF THE ELECTRONIC COMPUTER, (3) IMPROVEMENT IN HOSPITAL SUPPLIES AND SERVICES, INCLUDING THE USE OF DISPOSABLE iTEMS AND IMPROVED MATERIALS HANDLING EQUIPMENT, AND (4) IMPROVEMENTS IN THE MANAGEMENT AND STRUCTURAL DESIGN OF HEALTH FACILITIES FOR BETTER UTILIZATION OF PERSONNEL, EQUIPMENT, AND SPACE. IN GENERAL, CHANGING TECHNOLOGY WILL AFFECT HEALTH MANPOWER GRADUALLY. LABORSAVING INNOVATIONS WILL PROBABLY NEITHER CAUSE WORKERS TO LOSE THEIR JOBS NOR ALLEVIATE HEALTH MANPOWER SHORTAGES. CONTENT OF HEALTH JOBS WILL CHANGE, AND NEW JOBS WILL APPEAR AS NEW EQUIPMENT AND TECHNIQUES ARE INTRCDUCED, BUT THE DEMANDS FOR WORKERS WITH NEW SKILLS WILL PROBABLY NOT OUTSTRIP THE CAPACITY FOR TRAINING THEM UNDER WIDELY RECOMMENDED LONG-RANGE PLANS. ANTICIPATED EMPLOYMENT GROWTH FROM 1965 TO 1975 IS 75 PERCENT FOR X -RAY TECHNICIANS, 60 PERCENT FOR MEDICAL LABORATORY PERSONNEL, 55 PERCENT FOR REHABILITATION AND OTHER TECHNICIANS, AND MORE THAN 40 PERCENT FOR NURSING PERSONNEL. RECOMMENDED ARE THE REMOVAL OF WAGE AND EMPLOYMENT CONDITION INEQUITIES TO ATTRACT ALREADY QUALIFIED PERSONS BACK TO EMPLOYMENT, THE EXPANSION Cf GOVERNMENT AND PRIVATE TRAINING PROGRAMS, AND BETTER COORDINATION BETWEEN GOVERNMENT AND PRIVATE AGENCIES IN DEALING WITH HEALTH MANPOWER SHORTAGES. THIS DOCUMENT IS AVAILABLE FROM U.S. DEPARTMENT OF LABOR, MANPOWER ADMINISTRATION, OFFICE OF MANPOWER POLICY, EVALUATION, AND RESEARCH, WASHINGTON, D.C. 20210. (JK) NUMBER 14 MAY 1967 ,0 ; Technology and Manpower InThe U.S.,DEPARTMENTs!bF LABOR: W. Willard Wirtz, Secretary * ManpOwer Admintifratitm ,'J OTHER MANPOWER RESEARCH BULLETINS Mobility and Worker Adaptation to Economic Change in the United States (No.1, Revised 1963) Young Workers: Their Special Training Needs (No. 3, 1963) Selected Manpower Indicators for States (No. 4, 1963) Family Breadwinners: Their Special Training Needs (No. 5, 1964) The Mentally Retarded: Their Special Training Needs (No. 6, 1964) Training Foreign Nationals for Employment With U.S. Companies in Developing CountriesImplications for Domestic Programs (No. 7, 1965) Training Needs in Correctional Institutions (No. 8, 1066) Training in Service Occupations Under the Manpower Development and Training Act (No. 9, 1966) Unused Manpower: The Nation's Loss (No. 10, 1966) Manpower Policy and Programs in Five Western European Countries: France, Great Britain, the Netherlands, Sweden, and West Germany (No. 11, 1966) Technology and Manpower in Design and Drafting 1965-75 (No. 12, 1966) Technology and Manpower in the Telephone industry 1965-75 (No. 13, 1966) 00 I p 1/ Pt U.S. DEPARTMENT OF HEALTH, EDUCATION &WELFARE OFFICE OF EDUCATION THIS DOCUMENT HASBEEN REPRODUCED EXACTLY AS RECEIVEDFROM THE PERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OROPINIONS STATED r' NOT NECESSARILY REPRESENT OFFICIALOFFICE OF EDUCATION POSITION OR POLICY. Technology and Manpower In The HEALTH SERVICE INDUSTRY 1965-75 U.S. DEPARTMENT OF LABOR: W. Willard Wirtz, Secretary MANPOWER ADMINISTRATION Preface Technological change has brought about vast changes in the social and economic structure of the United States.Of significant importance for more than a century, the influence of technology has been especially noticeable in the last two decades. Technological advances made during World War II established the foundation for many entirely new products and industries. More recently, Government military and space research expenditures, combined with greatly increased industrial spending for research and development, have produced an abundance of technological advancements which promise to have an even greater influence on our economy. Technological change has important effects on the labor force.Existing occupations are eliminated, others decline in importance; totally new occupations come into existence, job content changes, and new skills are required.Although a wide variety of mechanisms are available to facilitate manpower adjustment to technological change, planning lies at the core of each.The U.S. Department of Labor has for many years recognized in its research programs the need for advanced information on the potential impact of technology. Early in 1965, an experimental and demonstration project was launched within the Department of Labor as part of the Department's continuing efforts to refine and improve its research methods. The project was aimed at using interpretive analysis techniques, based on extensive industry inter- views, to fill gaps in facts and judgments needed for planning manpower development efforts by industry, union, and school systems and for program and policy development within the Department of Labor.Three industries and functional areas in which technology is expected to have important manpower effects were selected and studied in depth.They are: The health service industry (covered in this report) ; the design/drafting process (see Technology and Manpawer in Design and Drafting, 1965-75) ; and the telephone communications industry (see Technology and Manpower in the Telephone Industry, 1965-75). This report was prepared by Herman M. Sturm under the supervision of Peter E. Haase, project director, and under the general direction of Curtis C. Al ler, director, Office of Manpower Policy, Evaluation, and Research. Hi 4.111MFIMINIM, Contents Page 1 INTRODUCTION 3 OVERVIEW 3 The manpower background 3 and expectations Technological developments 4 The outlook for health manpower 7 1. MANPOWER INHEALTH FACILITIES expenditures and facilities 7 Trends in health service 7 Health service expenditures 8 service facilities Hospitals and other health 11 establishments Employment in health service 11 of health facilities Organization and staffing 13 occupations Employment in health service 15 earnings Labor costs vs. employee 16 conditions Wages, hours, and working 18 Critical needs for health manpower 18 Seventeen key jobs 20 The nurse shortage 23 Medical laboratory personnel 1 llatA 'AT Ty't A /V T T_T1M A T f^I -T _ - -1 V V 1:41%. 11'1 Arat1.1., .11. FALAILITLE' Page MDTA programs for training health manpower 24 2. TECHNOLOGICAL DEVELOPMENTS AFFECTING MANPOWER 27 Effects of medical research and public health programs 28 Recent trends in causes of hospitalization 28 Medical research 30 Public health programs 31 Technological developments in patient care facilities 35 Developments in diagnosis and patient care 35 Hospital information handling 44 Developments affecting hospital supply and service 53 Improvements in the functioning and design of health facilities 60 3. OUTLOOK FOR HEALTH MANPOWER, 1965-75 69 Expected trends in demand and productivity affecting health jobs 70 Employment in health occupations, 1965 -75. 73 Expected differences among occupation groups 74 Limitations of projections 75 New and changing occupations 77 Developing and conserving the health manpower supply 79 Programs for training health manpower 80 Harnessing money incentives 82 Needs for information and research programs 83 APPENDIX A. Definition of the health service industry 87 B. Statistical appendix 89 C. Appendix tables 95 D. Selected references 99 E. Interviews 107 TABLES AND CHARTS Tables 1. Patterns of hospital utilization, 1964 9 2. Estimated employment inhealth serviceindustry establishments, by occupa- tion, 1965 14 3. Employees of nongovernment hospitals earning less than $1.25 per hour, in selected occupations, 1963 16 4. Authorized trainees in health occupations funded under the MDTA, August 1962 December 1966 25 5. Causes of admissions to short-term general hospitals, study of 64 hospitals,1946, 1954, and 1961 29 vi TABLES AND CHARTSContinued Tables Page 6. Short-term non-Federal hospitals purchase of selected disposable products, 1958, 1960, and 1962 57 7. Trends in utilization of selected hospital items and services: Ratiosper hospital ad- mission, 1946, 1954, and 1961 72 8. Estimated employment in health service industry, by occupationgroup, 1965, 1970, and 1975.. 73 Charts 1. Growth in employment will vary widely among occupationgroups in next decade 5 2. Religious, charitable, and other voluntary groups lead as hospitalowners 10 3. Typical large general hospital organized into five divisions 12 4. Turnover of nurses dwarfs turnover of teachers 22 5. Total information system schematic, a State public health department 33 Y 6. Number of beds is rising faster in nursing homes than hospitals 71 vi' Introduction In recent years the demand for medical and million persons arc active in health service and other health services has been increasing rapidly. related fields.The number of jobs