Data source

National Health Workforce Data Set (NHWDS)

In 2010, the National Registration and Accreditation Scheme (NRAS) was introduced and the AIHW labour force surveys were replaced with workforce surveys administered under the NRAS. These new national surveys are administered by the Australian Health Practitioners Regulation Agency (AHPRA) and are included as part of the registration renewal process. The surveys are voluntary, and are used to provide nationally consistent estimates of the health workforce. They provide data not readily available from other sources, such as:

  • the type of work done by, and job setting of health professionals
  • the number of hours worked in a clinical or non-clinical role, and in total and
  • the numbers of years worked in, and intended to remain in, the health workforce.

The survey also provides information on those registered health professionals who are not undertaking clinical work or who are not employed. The information from the workforce surveys combined with registration data items make up the NHWDS.

A detailed description of the 2015 NHWDS for medical practitioners including psychiatrists, and nurses and midwives are available from the AIHW Metadata Online Registry. A detailed description of the 2015 NHWDS for allied health professionals including psychologists is not available at this time.

Response rates

The overall response rate to the Medical Workforce Survey in 2015 was 94.8%, that is, the number of responses to the survey represented 94.8% of registered medical practitioners (Department of Health, 2017). New South Wales (95.6%), Victoria (95.1%) and Tasmania (94.8%) had the highest response rates. Northern Territory (93.4%) and South Australia (93.0%) had the lowest response rates.

The overall response rate to the Nursing and Midwifery Workforce Survey 2015 was 91.5% (Department of Health, 2017). Tasmania (92.6%), Western Australia (91.9%), New South Wales (91.7%), and Victoria (91.5%) had the highest response rates. The lowest response rate was for Northern Territory at 89.4%.

The overall response rate to the Psychology Workforce Survey by psychologists with a full registration was 97.2% (Department of Health, 2017). Victoria (97.7%), Queensland (97.5%), Australian Capital Territory(97.3%) and New South Wales (97.2%) had the highest response rates. The lowest response rate was for South Australia at 95.4%.

Estimation procedures

The AIHW uses registration data together with survey data to derive estimates of the total health practitioner workforce. Not all practitioners who receive a survey respond, as it is not mandatory. In deriving the estimates, two sources of non-response to the survey are accounted for:

  • Item non-response—occurs as some respondents return partially completed surveys. Some survey records were incomplete to such an extent that it was decided to omit them from the reported survey data.
  • Survey non-response—occurs because not all registered practitioners who receive a questionnaire respond.

Imputation methods are used account for item non-response and survey non-response.

Imputation: estimation for item non-response

The imputation process involves an initial examination of all information provided by a respondent. If possible, a reasonable assumption is made about any missing information based on responses to other survey questions. For example, if a respondent provides information on hours worked and the area in which they work, but leaves the workforce question blank, it is reasonable to assume that they were employed.

Missing values remaining after this process are considered for their suitability for further imputation. Suitability is based on the level of non-response to that item.

In imputation, the known probabilities of particular responses occurring are used to assign a response to each record. Imputed values are based on the distribution of responses occurring in the responding sample. Therefore, fundamental to imputing missing values for survey respondents who returned partially completed questionnaires is the assumption that respondents who answer various questions are similar to those who do not.

Age values within each state and territory of principal practice are first imputed to account for missing values. Other variables deemed suitable for this process were then imputed. These include hours worked in the week before the survey, principal role of main job, principal area of main job and work setting of main job.

Imputation: estimation for population non-response

In 2013, the methodology for population non-response was changed from a weighting-based methodology to a randomised sequential hot deck-based imputation.

The data were sorted into strata, so imputations were made using survey data from records that have similar registration details. The strata used for imputation were registration type (with limited registrants grouped together and specialist registrants grouped with those who also had general registration), a derived primary specialty categorisation, sex, age group, remoteness area and state, in that order.

Donor records were spaced evenly within strata to ensure records were used within the strata an equal number of times plus or minus 1, and that most strata within the hot deck were restricted to within strata imputations. For example, if there were 5 respondents and 12 non-respondents in a cell, the expected number of uses would be 2.4, resulting in each donor being used either 2 or 3 times. This is almost equivalent to a weighting strategy, except that instead of all the data being weighted only the non-registration data are weighted.

Because the data were imputed and not weighted, some data may be affected in different ways from those previously published. For example, because a practitioner's location of main job is most likely to be the same as their registration address, this has been used for the location estimation of non-respondents. Using this estimate rather than weighting will improve the accuracy of estimates for small geographic areas, as previously weighted data would scale up data for individuals across the state/territory and the registration information for records would not be taken into account.

For variables not used in the imputation (that is, all variables other than the registration type, remoteness area, state and territory of principal practice, age and sex), it is assumed, for estimation purposes, that respondents and non-respondents have the same characteristics. If the assumption is incorrect, and non-respondents are different from respondents, then the estimates will have some bias. The extent of this cannot be measured without obtaining more detailed information about non-respondents.

Location

State and territory is derived from state and territory of main job where available, otherwise, state and territory of principal practice is used as a proxy. If principal practice details are unavailable, state and territory of residence is used. For records with no information on all three locations, they are coded to Not stated. Remote and very remote areas include migratory areas.

In 2010, data for medical practitioners exclude Queensland and Western Australia due to their registration period closing after the national registration deadline on 30 September 2010.

Past and present surveys have different collection and estimation methodologies, questionnaire designs and response rates. As a result, care should be taken in comparing historical data from the AIHW Labour Force Surveys with data from the National Health Workforce Data Set.

AIHW labour force surveys

Prior to the introduction of the NRAS and the NHWDS in 2010, the AIHW Medical Labour Force Survey and the Nursing and Midwifery Labour Force Survey were conducted by the state and territory departments of health with the cooperation of the medical and nursing registration boards in each jurisdiction, and in consultation with the AIHW. The AIHW was the data custodian for these national collections and was responsible for collating, editing and weighting the survey data to provide nationally consistent estimates.

The AIHW Medical Labour Force Survey was a survey of all registered medical practitioners in each state and territory in Australia. The AIHW Nursing and Midwifery Labour Force Survey was a survey of all registered nurses and midwives in each state and territory in Australia. The surveys were mail‑outs conducted in association with the annual registration renewal process. The Medical Labour Force Survey was conducted annually from 1993. The Nursing and Midwifery Labour Force Survey was conducted every 2 years from 1995 to 2003, and annually from 2003 to 2009, excluding 2006. Other AIHW health workforce surveys were conducted irregularly. The Psychology Labour Force Survey was last conducted in 2003 (AIHW 2006).

In the surveys, information on demographic details, main areas and specialty of work, qualifications and hours worked was collected from registered professionals. The data collected generally related to the week before the survey for medical practitioners and nurses. Survey responses were weighted by state, age and sex (and the number of registered and enrolled nurses for nursing) to produce state and territory and national estimates of the total medical labour force and nursing and midwifery labour force. Benchmarks for weighting came from registration information provided by state and territory registration boards.

The response rates to these surveys varied from year to year and among jurisdictions. In 2009, the estimated national response rate for the Medical Labour Force Survey was 53%, ranging from 32% for Queensland to 79% for New South Wales (AIHW 2011a.

For the Nursing and Midwifery Labour Force Survey, the response rate declined from 61% in 2004 to 45% in 2009. In 2009, response rates in Queensland, Tasmania, the Northern Territory, Victoria and Western Australia ranged from 28% to 35% (AIHW 2011b).

As a result, historical estimates for states and territories included in this report should be treated with care. The national estimates were based on census results from all jurisdictions, as the effect of any bias in responses from states with low response rates was likely to be relatively small at the national level.

The survey questionnaire has varied over time and across jurisdictions for both surveys (although more so for the nursing than for the medical survey). Mapping of data items has been undertaken to provide time series data. However, because of this and the variation in response rates, some caution should be used in interpreting changes over time and differences across jurisdictions.

More detailed information about how these surveys were conducted is available from the Medical labour force 2009 (AIHW 2011a) and Nursing and midwifery labour force 2009 (AIHW 2011b ), and Psychology labour force 2003 ( AIHW 2006).


 

References

AIHW 2006. Psychology labour force 2003. AIHW cat. no. HWL 34. Canberra: AIHW.

AIHW 2011a. Medical labour force 2009. AIHW bulletin no. 89. Cat. no. AUS 138. Canberra: AIHW.

AIHW 2011b. Nursing and midwifery labour force 2009. AIHW bulletin no. 90. Cat. no. AUS 139. Canberra: AIHW.

AIHW 2016. Medical practitioners overview 2015. AIHW. Viewed 7 March 2017.

AIHW 2016. Who are nurses and midwives? Australian Institute of Health and Welfare website. Viewed April 2017.

Department of Health (DOH) 2017. National Health Workforce Data Set (NHWDS): Registered and Employed Practitioners Workforce Survey Response Rates 2015. Unpublished.

National Health Workforce Planning and Research Collaboration 2011: Mental Health Non-Government Organisation Workforce Project Final Report. Adelaide: Health Workforce Australia.

Psychology Board of Australia 2017. General registration. Viewed 24th April 2017.

Psychology Board of Australia and Australian Health Practitioners Regulation Agency (AHPRA) 2015. Registrant Data: 31 December 2015. Viewed 14 February 2017.

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