Full-time Equivalent Research Articles

FRI520 Disparities In Available Surgeons And Specialty Physicians Providing Endocrine-related Health Care Coverage To Populations In South Texas And The Rio Grande Valley

Abstract Disclosure: V. Alia: None. E.W. Alvarado: None. E.M. Diaz: None. H. Reinhart: None. Introduction: The Rio Grande Valley and South Texas is home to some of the most medically underserved populations in the nation, with gaps in health care ranging from low rates of adequately insured individuals, to the amount of primary and specialty healthcare services available [1]. Populations living in these areas near the Texas-Mexico border have some of the highest incidence of metabolic and endocrine-related disease in the U.S., while paradoxically having a large deficit in endocrine-specialists available to meet the medical and surgical needs of the community [1,2,3]. Methodology: We analyzed data from the National Center for Health Workforce Analysis (NCHWA), as well as data from the Texas department of state health services (TDSHS) to determine current and projected endocrine-related healthcare coverage needs in South Texas and the Rio Grande Valley (RGV) between 2013 to 2025 and 2018 to 2032 respectively [2,3]. Results: Analysis of the data provided by the NCHWA revealed that by 2025 the southern region of the U.S. is projected to have the largest shortage of full-time equivalent (FTE) surgical specialty physicians in the entire country with a deficit of 10,210 [3]. ​Additionally, data displaying critical-shortages provided by the TDSHS stated that in 2018 the percent demand met (PDM) for FTE endocrinologists in South Texas was only 76.6% with a projected decline to 65.7% by 2032 [2]. Noteworthy data from the TDSHS also stated that in 2018 the RGV specifically had a significant deficit in endocrinologists with a PDM of only 53.6%, while simultaneously having a projected increase to 66.4% by 2032 [2]. The TDSHS classified specialties in South Texas to be critically short when they are projected to have a deficit of ≥100 FTEs and <80% of the physician demand being met [2]. Conclusion: The collection of data analyzed led us to effectively identify significant disparities in endocrine-related healthcare coverage in the South Texas region, specifically the RGV. Additionally, new multidisciplinary healthcare institutions built in the RGV are striving to improve patient access to primary and subspecialty care by recruiting and training physicians in the area, but further action is still needed to counteract the described critical-shortages in physicians responsible for the long-term management of endocrine-related diseases. Presentation: Friday, June 16, 2023

What Indicators Are Shaping China’s National World-Class High-Tech Zones? Constructing a Feature Indicator System Based on Machine Learning

China’s high-tech parks have significant effects on driving national ecological innovation. Among them, ten world-class high-tech parks represent the highest level of development in China’s high-tech industry. Understanding the development characteristics of national world-class high-tech parks is of great significance for guiding the construction of other parks and achieving the high-quality development of parks. Based on the evaluation data of over 200 indicators of national high-tech parks from 2013 to 2017, this study used the XGBoost classic machine learning algorithm to select the characteristic indicators of national world-class high-tech parks and establish an evaluation indicator system, and it identified four primary indicators of the world-class high-tech parks, including innovation development, enterprise development, international development, and economic development. The indicators cover 30 important sub-indicators and highlight the importance of innovation resource input indicators, such as “use of technology activity funding from government departments”, “full-time equivalent of R&D personnel”, and “financial technology expenditure in high-tech parks”. Compared to the expert analysis, the application of the machine learning method in the evaluation of national high-tech parks improves the efficiency of selecting important indicators and makes the selection results more objective. The results of this research provide a reference value for guiding and promoting national high-tech parks to become world-class parks.

National Hospital and Health-System Controlled Substances Drug Diversion Prevention & Surveillance Program Assessment Survey - 2021.

To present and discuss the results of the National Hospital and Health-System Controlled Substances Drug Diversion Prevention & Surveillance Program Assessment Survey. The survey was emailed to 1,529 chief pharmacy officers utilizing the list of directors of pharmacy from the American Society of Health-System Pharmacists. The survey opened September 15, 2021, and closed October 4, 2021. Forty-nine questions were included in 5 different sections, and participants were also given the option to respond to 39 additional questions. The survey response rate was 12.75%, with the results showing consistencies in practice around drug security and human resource management. Sixty-two percent of sites had a formalized drug diversion committee, half of which had been implemented since 2018. Adoption of electronic controlled substance systems continues to increase, with 50% of sites having implemented such a system in the previous 3 years. At the time of the survey, 18% of organizations did not have an electronic system, but 90% of sites had implemented or intended to implement one by 2023. Over 40% of sites that utilized an electronic system were looking to upgrade to a next-generation system. Most organizations had 0.5 to 1 full-time equivalent dedicated to diversion prevention, and two-thirds of sites had a formalized diversion committee. The majority of sites defined "significant loss" by utilizing professional judgement, based on the scenario, as a percentage of inventory or as a range of units. Community practice consensus is needed around auditing adjustments to controlled substance inventory and for perpetual inventory processes. Respondents reported 1 to 2 (29%), 3 to 5 (26%), and more than 10 (26%) formal drug diversion investigations annually. This first-time survey provided significant insight into the realities of drug diversion prevention practices in hospitals and health systems nationally.

Impact of Economic and Environmental Factors on O3 Concentrations in the Yangtze River Delta Region of China

The concentration of atmospheric ozone (O3) pollution is showing a rapid growing tendency, and O3 pollution has become one of the bottleneck issues that restrict the continuous improvement of air quality in China. In this study, we first identified the primary factors based on the source apportionment of O3, then used factor analysis to divide these selected factors into economic and environmental categories. The geographical detector model was used to analyze the impact of factors and their interactions on O3 concentration in 41 cities in the Yangtze River Delta (YRD) region in 2020. The results showed that forest coverage ranked first among all the detected factors, suggesting a strong relationship between the regional O3 concentration and forest coverage. The driving factors of economic activity were ranked as follows: actual utilization of foreign capital (0.400) > gross domestic product (GDP) per capita (0.387) > proportion of tertiary industry (0.360) > urbanization rate (0.327) > per capita consumption expenditure (0.194) > research and development (R&D) of full-time equivalents of industrial enterprises above designated size (0.182) > number of industrial enterprises (0.126). The interaction between any two factors enhanced their influence on O3 concentration more than any single factor, indicating that the variability of regional O3 concentration was an outcome of a combination of multiple factors. This study could provide recommendations for the prevention and control of O3 pollution and the development of ecological integration in the YRD region.

Liaison librarian programs as described on U.S. college and university library websites

Case studies and surveys describing roles of liaison librarians and structure of liaison librarian programs have generally focused on libraries at large, research-oriented universities. This study was conducted to better understand the role of liaison librarians and the structure of liaison programs across more types of college and university libraries. Listings of liaison librarians on library websites at institutions with a wide range of enrollments were examined. Document analysis was used to observe how common it was for libraries to have such listings, how many liaison librarians were listed, what title was used for the position, what services were described, and if library employees not matched to university departments were also included in the list. Although there was substantial overlap in how institutions described their liaison librarian services, smaller and larger institutions had some noteworthy differences. Over 80 % of institutions with >5000 full-time equivalent (FTE) students had a liaison librarian listing on the library website, while less than half of smaller institutions had a listing. The largest institutions also tended to have more liaison librarians, frequently included subject specialization in liaison titles, and offered non-departmental services in their listings more often than smaller institutions.

Increased efficiency could lessen the need for more staff in companion animal practice.

To evaluate technical efficiency of US companion animal practices. 60 independently owned companion animal practices selected from the 2022 AVMA Veterinary Practice Owners Survey. A ratio of the weighted sum of outputs to weighted sum of inputs was computed for each practice (ie, decision-making unit [DMU]). Inputs included labor (hours worked) and capital (fixed costs and number of exam rooms). Outputs (or production) included annual gross revenue, number of patients seen per year, and number of appointment slots per full-time-equivalent (FTE) veterinarian per year. Data envelopment analysis was used to optimize the ratio and estimate relative efficiency (RE) scores. 25 (42%) practices were classified as having high efficiency (RE = 1 or 100% efficient), 26 (43%) as having moderate efficiency (RE > 0.7 but < 1.0), and 9 (15%) as having low efficiency (RE ≤ 0.7). Mean RE scores for moderate- and low-efficiency practices were 0.83 and 0.66, meaning they could have reached their current production levels with 17% or 34% less resources. Per the model, if all 60 practices were 100% efficient on the RE scale, 22 fewer FTE veterinarians, 47 fewer FTE veterinary technicians and assistants, and 43 fewer FTE nonmedical staff would be needed overall. These preliminary findings suggested that efforts to optimize efficiency could allow companion animal practices to meet demands for their services without necessarily needing to hire more staff. Such efforts might include engaging support staff to their full potential and implementing automated processes. Additional research is needed to identify routines or workflows that distinguish high-efficiency practices from others.

Broadening the state of play - the second national survey of Consultation-Liaison Psychiatry services in New Zealand, 2021.

The original national survey of Consultation-Liaison Psychiatry (CLP) services in New Zealand (NZ) that was undertaken in 2018 (CLPSNZ-1) established a baseline but was limited in scope. The aim of the current study was to conduct a more in-depth national survey. A 44-question survey was emailed to clinicians at each of the 16 general hospitals in NZ with specialist adult CLP services in 2021. Responses were obtained from all 16 CLP services. These services were found to be under-resourced (with mean total full-time equivalents of 0.26 psychiatrists and 1.10 clinicians per 100 inpatient beds, respectively), operate with highly variable service models (with major variations in operating hours and coverage of age groups, the Emergency Department and outpatients) and provide a predominantly consultation service. While many of the findings from CLPSNZ-1 remain relevant, the current survey has extended our understanding of the circumstances, achievements and challenges of this psychiatric subspecialty in NZ.

Simulating the Economic Effects of an Employer of Last Resort Program for Austria

Unemployment in Austria has increased considerably since the late 1970s, reaching its climax during the recent Covid-19 crisis with 409,639 individuals being registered unemployed in 2020. Conventional policy instruments appear insufficient to effectively address the persistent rise in unemployment over the decades. An increasingly prominent policy approach is the employer of last resort (ELR) which offers public employment at a base wage to everyone willing and able to work. The aim here is to simulate the economic effects of an ELR covering all registered unemployed people in Austria in 2020 using a static input-output model. The channel through which the ELR operates is the additional income generated by employing the unemployed. This income is assumed to translate into household consumption expenditure, ultimately spurring aggregate demand. The simulation results indicate that in a middle-bound scenario with respect to the programme wage, the ELR would raise output (Produktionswert) by 2.2% of GDP, value added by 0.9% of GDP, employee compensation by 0.4% of GDP and non-ELR employment by a total of 36,000 full-time equivalents. The results indicate that implementing an ELR programme would not only remove involuntary unemployment but also be accompanied by beneficial macroeconomic effects.

Intensive community care services for children and young people in psychiatric crisis: an expert opinion

BackgroundChildren and young people’s (CYP) mental health is worsening, and an increasing number are seeking psychiatric and mental health care. Whilst many CYPs with low-to-medium levels of psychiatric distress can be treated in outpatient services, CYPs in crisis often require inpatient hospital treatment. Although necessary in many cases, inpatient care can be distressing for CYPs and their families. Amongst other things, inpatient stays often isolate CYPs from their support networks and disrupt their education. In response to such limitations, and in order to effectively support CYPs with complex mental health needs, intensive community-based treatment models, which are known in this paper as intensive community care services (ICCS), have been developed. Although ICCS have been developed in a number of settings, there is, at present, little to no consensus of what ICCS entails.MethodsA group of child and adolescent mental health clinicians, researchers and academics convened in London in January 2023. They met to discuss and agree upon the minimum requirements of ICCS. The discussion was semi-structured and used the Dartmouth Assertive Community Treatment Fidelity Scale as a framework. Following the meeting, the agreed features of ICCS, as described in this paper, were written up.ResultsICCS was defined as a service which provides treatment primarily outside of hospital in community settings such as the school or home. Alongside this, ICCS should provide at least some out-of-hours support, and a minimum of 90% of CYPs should be supported at least twice per week. The maximum caseload should be approximately 5 clients per full time equivalent (FTE), and the minimum number of staff for an ICCS team should be 4 FTE. The group also confirmed the importance of supporting CYPs engagement with their communities and the need to remain flexible in treatment provision. Finally, the importance of robust evaluation utilising tools including the Children’s Global Assessment Scale were agreed.ConclusionsThis paper presents the agreed minimum requirements of intensive community-based psychiatric care. Using the parameters laid out herein, clinicians, academics, and related colleagues working in ICCS should seek to further develop the evidence base for this treatment model.

Midwifery workforce challenges in Victoria, Australia. A cross-sectional study of maternity managers

BackgroundIn Australia, there is a lack of accurate data on midwifery workforce staffing and skill mix, which in turn hinders workforce policy and planning. AimTo describe the current staffing levels of the midwifery workforce in Victoria, Australia, explore workforce challenges and assess the impact of COVID-19 pandemic on staffing. DesignCross-sectional. MethodsMidwifery managers in all public and private maternity services in Victoria, Australia were invited to complete a survey exploring midwifery staffing numbers and adequacy. Topics explored included midwifery turnover, recruitment, and skill mix. Descriptive statistics were used. FindingsThe survey was open March to October 2021, and 56 % (38/68) of managers responded. Of these, 76 % reported inadequate midwifery staff levels, with deficits ranging from one to 19 estimated Full-Time Equivalent (EFT) midwives, with a combined total deficit of 135 EFT. In the 12 months prior to the survey, 73 % of services had found it difficult to recruit midwives, with increased difficulty during the COVID-19 pandemic. Managers were concerned about retaining and recruiting ‘experienced’ midwives due to an ageing workforce and high turnover due to work/life imbalance and job dissatisfaction. These issues have led to a predominantly early career midwifery workforce and created concern about skill mix. ConclusionVictorian maternity services have a midwifery workforce shortage and are experiencing significant skill mix issues. The pandemic has exacerbated these considerable gaps in the workforce. Urgent implementation of retention and recruitment schemes are needed, along with strategies to improve the working conditions for the current workforce.

A case study of the impact of a dietitian in the multi-disciplinary team within primary care: a service evaluation.

Expanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence suggests dietitians can improve patient outcomes and make cost savings. The present study aimed to evaluate a dietitian working as an expert generalist and first contact practitioner (FCP) in a general practice multi-disciplinary team (MDT) to provide appropriate care to patients and reduce GP workload. A dietitian was employed for 6 months at 0.6 full-time equivalents in a group of general practices in Devon, UK. Data were collected on the referral source, patient satisfaction, health outcomes and changes in prescribing data for all patients seen by the dietitian. Focus groups and interviews provided data to understand the experience of introducing a dietitian into the team. This model of service delivery showed the dietitian acting as an expert generalist, a FCP and able to educate the MDT. A range of professionals within the MDT referred patients with a wide range of diagnoses (both paediatric and adults) and the dietitian acted as a FCP for 29% of patients. Saving were made for the optimisation of medicine management. The dietitian can improve patient-centred care for several patient groups; enhance learning for staff around nutrition and dietary issues; and contribute to more efficient working and cost savings around prescription of nutritional products. This was an evaluation of one service and further research is needed to understand the value dietitians can contribute and the factors supporting effective and efficient working in this context.

Health inequalities in the geographic distribution of dental practitioners in Costa Rica: An ecological study.

The uneven distribution of dental health services in a territory can cause an imbalance in accessibility, increasing health inequalities. This study aimed to describe the geographical distribution of dental health practitioners according to urbanicity and area-level socio-economic status in Costa Rica. A National Dentist Survey was developed to identify employment status, number of working hours, address and list of the working clinics. Data was completed using information from the national College of Surgeons, including all Costa Rican dentists. The Minimal Geographic Units (MGU) allowed for aggregating the population's individual level socio-economic position. Local Potential Accessibility (LPA) calculated the density of full-time hour's equivalents around each MGU using floating sectors. Clinics were geocoded using Geographic Information Systems, creating 2853 clinical points. Distance between each MGU and the nearest accessible clinics considering full-time working hours equivalents was estimated. MGU were divided into six categories: 'No accessibility', 'Very low accessibility', 'Low accessibility', 'Good accessibility' 'High accessibility' and 'Very high accessibility'. Mean national LPA was 6.5 full-time equivalents per 10 000 inhabitants, 3.4% of the Costa Rican population had no access to dentist; 12.9% had very low accessibility, 22.7% had low accessibility, 35.0% had good accessibility, 16.2% had high accessibility, and 9.8% had very high accessibility. Overall, 39% of the population has a rather low accessibility. LPA was higher in urban districts compared to rural districts and in wealthiest districts compared to most disadvantaged districts. Within districts, after adjustment for district's characteristics, LPA was higher in urban MGU compared to rural MGU and in wealthiest MGU compared to most disadvantaged MGU. This study found that despite having a high number of dentists, their numbers are small in many areas, increasing inequalities in access to health care. The dentist's free establishment, where they can decide to provide private services within a community, creates zones with very high densities, in particular in the wealthiest urban areas, and others with very low densities, in particular the poorest rural areas. The lack of territorial planning has been one of the reasons that has encouraged an imbalance in the availability of dental human resources. To achieve effective universal health coverage, public institutions should focus their efforts on improving access to dental services in underserved areas.

The structure, conduct, and performance of the hatchery segment of the aquaculture value chain in Bangladesh

IntroductionSeed production has experienced significant growth in Bangladesh over the last decade, driven by the increasing number of hatcheries. The hatchery segment plays a crucial role in the overall growth and development of aquaculture in the country. Understanding its structure, conduct and performance is essential for assessing its impact on the productivity and profitability of aquaculture farms. However, there is a limited number of methodologically rigorous studies focusing on the hatchery segment in Bangladesh. The study aimed to fill the gap in the exiting literature by conducting a methodologically analysis of the hatchery segment of aquaculture value chain in Bangladesh.MethodsThis study was conducted in seven of the main aquaculture producing districts in southern Bangladesh. A comprehensive structured survey was conducted between May and August 2022 with 66 enterprises, including 42 carp+catfish, 16 tilapia, and 8 crustacean hatcheries.Results and discussionThe major findings and their implications are as follows. (1) The number of hatcheries increased by 15% over the past decade, with a 27% increase in fish hatcheries and a 47% decrease in crustacean hatcheries. (2) Carp and tiger shrimp were the most commonly produced fish and crustacean seeds, contributing 67% and 99% of volume and 66% and 97% of sales value, respectively. (3) The hatcheries were family-owned and operated enterprise, and generated a total 2,491 full time equivalent (FTE) jobs. (4) Hatcheries used 86% of their broodstock annually and replaced them regularly for improving quality and avoiding inbreeding. (5) 18% of hatcheries reported facing diseases and/or water quality problems, but mean economic loss was only 0.71% of seed sales value, which is a low level of loss and waste. (6) Average annual net profit margin was relatively modest, averaging 54% of the gross revenue, which suggests the existence of competitive seed production and marketing. The results showed that the hatchery segment in southern Bangladesh appears to be dynamic, well developed, efficient, and relatively competitive.

Transformation of the feed supply segment of the aquaculture value chain in Bangladesh

The rapid growth of aquaculture in Bangladesh over the past three decades has been facilitated by increasing supplementary feed use and increasing numbers of feed suppliers, but little is known about the organization and behavior of the feed supply segment of aquaculture value chain. We conducted a comprehensive survey with 79 feed suppliers of two types: ‘dealers’ linked to feed companies (n = 34) and independent retailers (n = 45), in the seven main aquaculture producing districts of southern Bangladesh in 2021 to address this knowledge gap. We found the following. (1) Over the past 10 years, the number of traders increased 70% and the volume of feed traded almost doubled. (2) Feed supply is shifting from traditional agricultural byproducts to formulated feeds (47% of total feed), and floating feeds as a subset of those (54% of formulated feed), contributing to increasing farm productivity. (3) The formulated fish feed market in Bangladesh is diverse, but quite concentrated. Feed suppliers sold formulated feed produced by 35 companies, with eight companies accounting for 74% of sales. (4) Feed handling practices are efficient. Traders sell feeds quickly (average turnover time 10 days) and storage practices are adequate to maintain quality. (5) No traders reported experiencing any waste or loss of feed during their most recent completed transaction, and only 5% of traders reported losing a small portion of feed (1.7%) during transport. (6) The average profit margin earned by feed suppliers is a modest 6.2%. (7) Feed trading creates substantial employment: 43,937 full time equivalent (FTE) jobs in the seven surveyed districts. In sum, the feed supply segment of the aquaculture value chain in southern Bangladesh is dynamic, well-developed, and relatively competitive and efficient. This finding is contrary to the conventional wisdom, which often portrays the sector as inefficient and beset by problems.

Estimating a Regional Economic Conservation Benefit of Using Domestic Hardwoods vs. Apitong for Trailer Decking: A Case Study on US Army Use

United States Army trucks and trailers use an estimated one million board feet (2381 cubic meters) of a critically endangered tropical hardwood, apitong (Dipterocarpus spp.), from southeast Asian rainforests, for wood decking annually. However, their purchasing specifications require the use of domestic hardwoods for decking, floorboards, and platforms. Several US hardwood species, including northern red oak (Quercus rubra), white oak (Quercus alba), hickory (Carya spp.), black locust (Robinia pseudoacacia), and sugar maple (Acer saccharum) could serve as viable substitutes. They have comparable strength properties to apitong, and there is an abundant and sustainable feedstock based on the United States Forest Service Forest Inventory Analysis (USFS FIA) database. The economic impact in New York State of manufacturing the decking panels in Onondaga County from three selected species: hickory, white oak, and black locust, was estimated using IMPLAN. The economic impact could be as high as $27 million, creating 128 full-time equivalent (FTE) jobs. Equally important to providing local and regional economic benefits, domestically sourced decking panels also contributes to the preservation of tropical rainforests, particularly when the entire decking market is considered (beyond the US Army), which includes wood decking consumption by other government agencies at various levels and the private sector.

Expansion of around the clock critical care and emergency medicine clinical pharmacy services at a large urban academic medical center

AbstractThe impact of a pharmacist as a dedicated member of multidisciplinary intensive care unit (ICU) and emergency department (ED) teams has repeatedly been described in the literature for over 20 years. A 2020 position paper published by the Society of Critical Care Medicine and the American College of Clinical Pharmacy recommended the optimal practice model include critical care pharmacists providing direct patient care 24 h a day, 7 days a week. The objective of this paper is to describe the expansion and evolution of clinical pharmacy services provided in the ICU and ED at a large academic health center, beginning in 2015 and accelerated in the face of a global pandemic. This was made possible through a combination of creating new positions and reallocating existing positions to substantially increase ICU and ED clinical pharmacy coverage. Over a 7 year period, the emergency medicine and critical care clinical pharmacy team expanded from six full time equivalent (FTE) employees in 2015 to 16 FTEs in early 2022. This allowed for reduced pharmacist to patient ratios, the expansion of clinical pharmacy services from primarily weekday hours to a 24 h per day coverage model, 7 days a week, and to better support clinical pharmacy specialists providing these services. Rapid expansion of around the clock clinical pharmacy services was only possible through collaboration between clinical and operations pharmacy managers and feedback from members of the multidisciplinary team.

Population, workforce, and organisational characteristics affecting appointment rates: a retrospective cross-sectional analysis in primary care.

The recent publication of data on appointment volumes for all general practices in England has enabled representative analysis of factors affecting appointment activity rates for the first time. To identify population, workforce, and organisational predictors of practice variations in appointment volume. A multivariable cross-sectional regression analysis of 6284 general practices in England was undertaken using data from August-October 2022. Multivariable regression analyses was conducted. It related population age and deprivation, numbers of GPs, nurses, and other care professionals, and organisation characteristics to numbers of appointments by staff type and to proportions of appointments on the same or next day after booking. Appointment levels were higher at practices serving rural areas. Practices serving more deprived populations had more appointments with other care professionals but not GPs. One additional full-time equivalent (FTE) GP was associated with an extra 175 appointments over 3 months. Additional FTEs of other staff types were associated with larger differences in appointment rates (367 appointments per additional nurse and 218 appointments per additional other care professional over 3 months). There was evidence of substitution between staff types in appointment provision. Levels of staffing were not associated with proportions of same-or next-day appointments. Higher staffing levels are associated with more appointment provision, but not speed of appointment availability. New information on activity levels has shown evidence of substitution between GPs and other care professionals in appointment provision and demonstrated additional workload for practices serving deprived and rural areas.

How new clinical roles in primary care impact on equitable distribution of workforce: a retrospective study.

There are inequalities in the geographical distribution of the primary care workforce in England. Primary care networks (PCNs), and the associated Additional Roles Reimbursement Scheme (ARRS) funding, have stimulated employment of new healthcare roles. However, it is not clear whether this will impact inequalities. To examine whether the ARRS impacted inequality in the distribution of the primary care workforce. A retrospective before-and-after study of English PCNs in 2019 and 2022. The study combined workforce, population, and deprivation data at network level for March 2019 and March 2022. The change was estimated between 2019 and 2022 in the slope index of inequality (SII) across deprivation of full-time equivalent (FTE) GPs (total doctors, qualified GPs, and doctors-in-training), nurses, direct patient care, administrative, ARRS and non- ARRS, and total staff per 10 000 patients. A total of 1255 networks were included. Nurses and qualified GPs decreased in number while all other staff roles increased, with ARRS staff having the greatest increase. There was a pro- rich change in the SII for administrative staff (-0.482, 95% confidence interval [CI] = -0.841 to -0.122, P<0.01) and a pro- poor change for doctors-in-training (0.161, 95% CI = 0.049 to 0.274, P<0.01). Changes in distribution of all other staff types were not statistically significant. Between 2019 and 2022 the distribution of administrative staff became less pro-poor, and doctors-in-training became pro-poor. The changes in inequality in all other staff groups were mixed. The introduction of PCNs has not substantially changed the longstanding inequalities in the geographical distribution of the primary care workforce.

Determination of Physical Workload and the Ideal Number of Workers in Arsy Bakery using Full Time Equivalent (FTE) Method

Arsy Bakery is one of the MSMEs located in Karang Joang, Balikpapan. This bakery produces five types of bread: white bread, sweat bread, mocha bread, cheese chocolate bread, and three-flavored bread. Arsy bakery could produce approximately 4000 loaves of bread weekly. This study aims to calculate the quantity of physical workload of Arsy bakery workers based on Full Time Equivalent (FTE) method and determine the ideal number of workers required. FTE is a workload analysis method that measures the length of time to complete the tasks in production process. The workload quantity for every worker is obtained based on the time measurements and calculation results. Based on the results of this study, the amount of workload that carried out by Worker 1 is 1.67, meanwhile the amount of workload carried out by Worker 2 is 1.60. These values show that both workers can be categorized as overload. The total FTE value for two workers is 3.27 which means that there should be 3 employees to finish Worker 1 and Worker 2 tasks. In conclusion, Arsy Bakery needs to recruit 1 new employee to reduce high workload of the current employees.

ANALISIS BEBAN KERJA UNTUK MENENTUKAN KEBUTUHAN TENAGA KERJA MENGGUNAKAN METODE FULL TIME EQUIVALENT (FTE) PADA PT SO GOOD FOOD

Qualified human resources are the most important factor in an organization or company. Human resources are one of the factors that can be a source of excellence for an organization or company to achieve efficiency, effectiveness and productivity in carrying out its business. The role of human resources is very important at PT So Good Food. Efficiency in the field of human resources is related to the workload that must be borne by an organizational unit. Planning and managing human resources can be done by making an appropriate analysis of the activities that occur and the resulting workload or by optimizing the number of employees so that they carry out their work activities properly. One of the workload calculation methods is the Full Time Equivalent (FTE) method. This study aims to determine the workload received by each employee and determine the optimal number of workers at PT So Good Food using the Full Time Equivalent (FTE) method. Based on the results of calculations that have been carried out using the FTE method, purchasing and logistics managers obtained an FTE index of 1.25, which means less than 1.28, the workload is normal or fit, while the purchasing staff has a workforce of 3 people so that the total owned FTE index of 3.75 which is rounded to 4, in the finance and accounting staff which totaled 3 people, a total FTE index of 3.75 was obtained which was rounded to 4, and the account receivable staff had a total workforce of 3 people so that the total index Owned FTE is 3.75 which is rounded to 4, so the workload is overloaded so that an additional 1 worker is needed