Overview of APRN’s in Georgia Dr. Lisa Wright Eichelberger Co-Lead, GNLC Dean, College of Health Clayton State University September 21st, 2015
The Data
Health Status of GA
Health Status in Georgia • Overall Rank of 38th • No Change in Rank:
America’s Health Rankings 2014
– United Health Foundation
• Strengths – Low prevalence of binge drinking – Low occupational fatalities – Infant mortality decreased 48% since 1990 – Low rate of drug deaths
Challenges in Georgia
• Rank 48th in high school graduation • Ranks 46th in low birthweight/insurance coverage • Rank 45th in availability of dentists • Rank 42nd in Air Pollution • Rank 39th in High BP • Rank 38th in CV deaths • Rank 37th in Diabetes • Rank 36th in Primary Care Physicians • Rank 33rd in obesity rate
Leading Causes of Death*, Georgia Number of Deaths 2007-2011 Cancers Diabete s 2 Column 80000
70000
60000
50000
Series 1
40000
Series 1
30000
20000
10000
0
Series 1
Health of Georgians • Dealing with Multi-Factorial Issues • Air pollution, Public Health Funding, Graduation Rates - all impacting health • Focus on Primary Care – APRN practice • Who delivers Primary Care? • What is it?
Definition of Primary Care • “The provision of integrated, accessible health services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” IOM Committee on Future of Primary Care
• PCP = General, Family Medicine, Ped, Internal Med. Geriatrics, FNP, PA
PCP/Primary Care Doctors • Measured by the number of PCD per 100,000 • Range from 200.8/100,000 in Massachusetts to 80.1/100,000 in Idaho. National average is 123.5/100,000 • GA ranks 36th with 105.4/100,000 • AAMC ranked GA 39th 2010 up from 40th in 2008 – 6 counties without Family physicians, • Work life not as long
Physician’s Assistants • In 2015, 91,921 PAs in US • In 2010, 27,700 PAs active in primary care • 1/3 PAs practice in primary care - projected forward 8,000 in 2020 • 173 accredited PA programs in 2013 • In GA, one public PA program, three private • GA is ranked 35th in number of PAs per 100,000 • 49 counties do not have PA, 3/10 work in Primary Care • 3,536 PAs in 2015 Kaiser Foundation
National Overview of APRN’s • CRNA’s graduates – grew from 1,159 to 2,447 2001 to 2011 • CNM graduates – decreased from 422 to 392 in 2001 to 2011 • NP graduates – grew from 7,261 to 12,273 2001- 2011 • Nationally 174, 826 NP’s licensed
Overview of NP’s • Number of active NP’s (110,800) has doubled from 2002 to 2012 NSSRN 2010 • In 2014, there were more than 205,000 nurse practitioners (NPs) licensed in the U.S. • 8,752 licensed NP’s in GA • Average age 49 yo • Half of NP’s (55,400) are in primary care in 2010. • AACN data indicates graduating more NP’s each year
– 12,273 - 2011, 14,400 - 2012, 15,000 - 2013 – ? Graduating in GA – Incomplete AACN data
Overview of APRN’s in GA as of Sept 21st 2015 • CRNA - 1,863 • CNM – 498 • NP – 7,537 • CNS/PMH – 271 • CNS – 132 • RN’s – 124, 508 • Licensed Undergraduate Nurse – 5 • Sos.ga.gov/cgi-bin/activelicenses.asp
AACN Georgia 2014 APRN Enrollments • 3,593 studying to be APRN’s including • 3,499 in Nurse Practitioner programs, • 79 in CRNA programs, • 11 in Clinical Nurse Specialists, and • 4 Certified Nurse-Midwife programs.
Settings GA APRN Employment 17
CNMs
CNSs
CRNAs
NPs
Hospital
173 69 8 0 2
617 116 64 17 26
980 205 3 1 2
1470 1289 154 58 22
Nurs Home/Extended Care/Assisted Living
2
49
6
115
Home Health
9 33 1 2 68 16 0
66 71 14 15 155 45 3
6 14 2 1 45 1 0
124 234 67 56 923 304 3
383
1,258
1,266
4,819 = 7,726
Ambulatory Care Public Health Occupational Health Insurance Claims/Benefits
Academic Setting Correctional Facility School Health Service Other Community Health Policy/Planning/Regul atory Agency Total
Race/Ethnicity of GA APRN’s CNS White – 65% Black – 26% Hispanic – 2% Asian – 5% Alaska Native/American Indian - <1% Native Hawaiian/Other Pacific Islander - <1% Other 3%
NP White - 76% Black – 18% Hispanic – 2% Asian – 3% Alaska Native/American Indian - <1% Native Hawaiian/Other Pacific Islander - <1% Other – 2%
CNM White – 77% Black – 14% Hispanic – 2% Asian – 5% Alaska Native/American Indian <1% Native Hawaiian/Other Pacific Islander - 0 Other – 3%
CRNA White – 83% Black – 12% Hispanic – 2% Asian – 3% Alaska Native/American Indian - <1% Native Hawaiian/Other Pacific Islander - <1% Other – 2%
Gender/Age of GA APRN’s • Gender – GA • CNM: Female - 98%, Male – 2% • CNS: Female – 91%, Male – 9% • CRNA: Female – 63%, Male. – 37% • NP: Female – 93%, Male – 7% • Total: Female – 88%, Male – 12% Nationally, 9% Male • • Avg. Age - GA • CNM: 47 • CNS: 52 • CRNA: 47 • NP: 46 • Total: 47
Avg. Age Nationally of all nurses Total: 47
Conclusion • Redesign of survey question • Type of NP practice • Continue to learn and refine process
Thank you!