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REPORT: Direct-Care Workers Undervalued and Underused

July 30, 2014

Direct-care workers are among “the most underutilized and undervalued members of the healthcare workforce,” a July 2014 report from the Brookings Institution says.

The report, “Part of the Solution” (pdf), analyzes the large segment of the U.S. health care workforce that is comprised of “pre-baccalaureate” workers, or those who have less than a bachelor’s degree.

Using employment data from 2009-11, the report’s authors, Martha Ross, Nicole Prchal Svajlenka, and Jane Williams, list the health care occupations with the greatest number of pre-baccalaureate workers.

The occupational grouping “nursing, psychiatric, and home health aides” came in first in the report’s list, with more than 1.2 million workers reported in the country’s 100 largest metropolitan areas. Personal care aides, meanwhile, came in third, with 542,000 pre-baccalaureate workers.

Overall, pre-baccalaureate workers comprise nearly one half (49 percent) of the health care workforce in the U.S.’s largest metropolitan areas.

Enhanced Roles

The authors argue that the skills of pre-baccalaureate health care workers are significantly underleveraged within the overall health care workforce. With the right policies in place, these workers could “play enhanced roles in providing high-quality care in a more efficient manner and at lower cost,” they write.

Direct-care workers in particular could help improve quality of care, the authors argue.

“By virtue of their regular contact with patients, [direct-care workers] are well-positioned to observe health condition changes, identify problems, and facilitate communication between the patient and the rest of the health care team to improve care,” they write.

“Additional training and redesigned care teams to take advantage of direct-care workers’ knowledge should be a priority,” the authors continue.

The report cites several PHI sources, including remarks made by PHI Strategic Advisor Steven Dawson at a March 2012 Senate briefing on the evolving role of home care workers, as well as the December 2011 report Caring in America, a comprehensive analysis of the country’s home health and personal care aide workforces.

— by Matthew Ozga

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