Managers of Health Services in Australia 2006-2016
Purpose: Activity in health services is expanding faster than population growth and that of the production of all goods and services in Australia. This paper is concerned with the number and characteristics of its managers in relation to the number of people employed and resources used. It also assesses different trends in hospitals and other medical and health services.
Methodology/Design: Design of the analyses follows specifications set by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2016.
Analysis: Assesses changes in the number and variations in the characteristics of managers of hospitals and medical and other health services, in relation to the number of people employed, contrasted with changes in all industries.
Findings: There are different trends in hospitals and medical and other health services, with a decline in the number of employees per manager in medical and other health services and a slight rise in hospitals. The older average age of health service managers continued to rise, similarly to that for all industries. The proportion of female managers in health services, below the average for all employees, increased somewhat during the decade. The distribution among the various fields of study remained about the same; but level of education, higher than the average for all industries continued to rise.The growth in average income of managers during the decade was somewhat lower than in all industries, due to a lower increase rate in medical and other health services. The proportion of managers of indigenous status rose substantially - almost double the proportion in all industries.
Implications: The findings are of relevance to those concerned with the management of health services and training of the growing number of managers of health services in Australia.
Health Service Managers in Australia Part 1: service, geographical and category distribution
This article is the first of a four-part series in which the authors provide analyses on the composition and characteristics of health service managers in Australia of relevance to policy and decision-making in dealing with these issues. This first article provides analyses on the specific characteristics of service, geographical and category distribution in both the public and private sectors. It gives an estimated number of managers in health services and aged care residential services in relation to the population they serve, as well as their relationship to people employed. It compares these ratios to those for all industries in Australia. The analyses also document and review managers by category and specialisation and compare their composition to the average for all industries. Substantial differences in composition between hospital, medical and other services, aged care residential services and the average for all industries arise from the analyses. Disparities in ratios to population and composition were also found among the various states and territories. The article also discusses the wide range of ratios of health service managers to population in some countries and their lack of consistency. The discussion of findings includes an agenda for future research.
Managers of Aged Care Residential Services
This article provides analyses of the number and characteristics of managers of aged care residential services in Australia at the time of the 2011 Census of Population. It documents the growth in capacity of these services, number of people employed and managers. The paper goes on to assess the diversity in the geographical distribution of managers. It examines the age and sex characteristics of managers in aged care residential services and compares them to health services and all industries. It estimates and reviews the average age of female and male managers at different levels of management. The analysis of the fields of study of these managers reveals the different pattern of the field of study of managers in aged care residential services and their level of education in comparison to the average for all industries. It also discloses gendered specialisation in the fields of study. Other analysis estimates the average income of managers in aged care residential services in comparison with those in health services and average in all industries. It examines the income of managers at different levels, with diverse levels of education and functions, and also differences in income of female and male managers. The analysis of marital status discloses a pattern in aged care residential service managers that is distinct from the pattern for all industries. The paper examines the changing origins of managers of aged care residential services according to their country of birth. It also assesses the relative representation of Indigenous people in the manage-ment of these services. Finally, it discusses issues of relevance to the organisation and management of aged care residential services and the training of their managers.
Health Service Managers in Australia: progression and evolution
This paper contains analyses of the number and characteristics of health service managers in Australia at the time of the 2011 Census of Population. It updates the work carried out by the authors in relation to the 2006 Census. It gives an estimate of the number of managers in hospitals and medical and other health services separately and as an aggregate. It relates the number of managers per type of service to the resident population and the number of people employed in each service and compares them to averages for managers in all industries. Further, it estimates changes that have taken place between 2006 and 2011. The analyses include the diversity in managers in four categories: chief executive officers/general managers, managers not further defined, specialist and service managers. The paper goes on to examine the age of managers by sex and how they compare with the average for all industries, and some of the factors that might affect the differences encountered. It also investigates changes in the age of managers in the five-year period 2006- 2011. In addition, the relative importance of the various fields of study and levels of education of health service managers are examined, as well as changes that have taken place in the inter-census period. The income of health service managers and the hours that they worked are assessed and compared to the average for all industries. Marital status is compared with the average for all industries and differences due to age and sex are considered. The analyses are concerned with evolving trends in the country of birth of health service managers and the Indigenous status of managers in hospitals and medical and other health services, in comparison with the average for all industries. Finally, the paper discusses findings and some of their implications for health service management training and career path development.
Health Service Managers in Australia Part 4: hours worked, marital status, country of birth and Indigenous status
This fourth article adds to the findings of the three previous articles in a four-part series. These articles are concerned with the composition and characteristics of health service managers in Australia. The data and analyses present factual bases with a bearing on policy formulation and planning of the health labour force in Australia and the training of managers. The first article provided analyses on the specific characteristics of service, geographical and category distributions of health service managers, the second on age and sex, and the third on fields of study, level of education and income characteristics of health service managers. This fourth article investigates hours worked, marital status, country of birth and Indigenous status of health service managers in Australia. Findings confirm that a large proportion of health service managers worked part time and female managers more so than males. Partly as a result of this difference, male managers worked on average longer hours than females, but even full-time female managers worked on average shorter hours than males. The average hours worked was lower than the average for managers in all industries in Australia. When adjusted for differences in age from the average for all industries, a larger proportion of health service managers than average had never married and were divorced or widowed. Conversely, a lower proportion than average were married. More than the average proportion of managers in hospitals were born in Australia, while the inverse was the situation in medical and other health services. The share of Australian-born was about average in aged care residential services. Indigenous health service managers constituted a larger percentage of managers than the average in all industries. Their participation in hospitals was lower than in medical and health services; and about the average for all industries in aged care residential services. In all cases, their participation in the management of health services was lower than their proportion in the adult population. The article presents challenges in policy formulation regarding working conditions and the participation of varied segments of society in the management of health services. It also points to a related research agenda.
Health Service Managers in Australia Part 3: field of study, level of education and income
This article is the third by the authors in a four-part series. They deal with the composition and characteristics of health service managers in Australia of relevance to policy and decision-making for the health service labour force in general and health service managers in particular. The first article provided analyses on the specific characteristics of service, geographical and category distribution of health service managers, while the second imparted factual perspectives on age and sex characteristics. The analyses in this third article involve the fields of study, levels of education and income of health service managers in Australia, at the time of 2006 Census of Population. Findings show that health service managers tended to have a higher degree of concentration in health and management/ commerce fields of study than the average for all industries. This also applied to managers in aged care residential services. The majority of females in the health labour force was reflected in most fields of study, with notable exceptions such as engineering and architecture/building. Health service managers had higher levels of education than the average for all industries. This was especially so in the case of hospital managers but also applied to other health services and to a lesser degree in aged care residential services. A larger proportion of female managers in health services had qualifications at bachelor and postgraduate levels than male managers, particularly in hospitals. The same applied to aged care residential services. Following their higher level of academic qualifications, the average income of managers in health services was higher than the average for all industries. There were substantial gaps between the average income of male and female managers in health services and aged care residential services. Some factors that contributed to this difference could be attributed to the higher proportion of female managers working less than full time but other factors must also have been responsible for this difference. The article raises policy and training questions and suggests a related agenda for research.
Competencies & Skills for Management of Systemic Changes in Australian Health Services: A predisposing, enabling and transforming framework
• Academic enhancement of management competencies/skills. The best method of imparting/acquiring the competencies/skills identified might not be academic. Examination of the three courses learning outcomes shows low content. - Innovative thinking - Managerial behaviour style and practice - Management of clinical practice (except risk management)
Human dimension of health service management
This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevance to the human dimension of health management, namely personal engagement at work, emotional intelligence and conflict resolution, were found to: (1) have concept validity; (2) be associated with personal and organisational performance; and (3) be capable of being imparted by training. The analysis indicated that none of the competencies and/or skills identified has been given emphasis in postgraduate health management courses in Australia. Competence in the management of human relationships in health services has been given low priority in university postgraduate training in health management in Australia. The current situation poses challenges to all stakeholders of health services.
Health Service Managers in Australia Part 2: age and sex characteristics
This article is the second in a four-part series in which the authors provide analyses on the composition and characteristics of health service managers in Australia of relevance to policy and decision-making in dealing with the future of health service labour force in general and health service management in particular. The first article presented analyses on the specific characteristics of service, geographical and category distribution. This second article provides analyses on age and sex characteristics of health service managers in Australia. Findings confirm that the health services labour force was older than the labour force at large at the time of the 2006 Census of Population and that health service managers were also older than those in all industries. The age distribution of managers in health services showed skewness towards younger ages. As expected, those in senior positions tended to be older. Managers in aged care residential services were even older on average, following the older average age of the labour force in these services. In general, female managers tended to be younger than male managers. There was not much difference in the average age of health service managers among the states and territories. The same was the experience in aged care residential services. In a labour force where females were predominant, the majority of managers in health services and aged care residential services were also females. However, their proportion of managers was lower than their proportion in the labour force of these two services. Further, the gap between the proportion of females in the labour force and the proportion of managers was larger in health services and especially aged care residential services than that in all industries. The gap became larger when the positions of chief executive officer and general manager were considered. The article also discusses a number of related policy issues and suggests an agenda for future research.
Competency in innovation, creative and innovative thinking: challenges within the Health Management course curriculum
Although competencies in innovation, creative and innovative thinking have been shown to be required by health managers and leaders, studies suggest that formal postgraduate health management programs do not include many of these required proficiencies. In this study, we undertook a content analysis of the syllabus information available on the public domain for each of the postgraduate Health Management programs delivered by universities in Australia. The results showed that, in the courses examined, there was a shortage of content concerned with creative and innovative thinking and innovation. The dilemma faced is how to incorporate this much needed content into the program. This is an issue since the curriculum is often characterised by a shortage of relevant and available health-related material, and is generally packed with so much content that there is little room to add any further matter. An important consideration is whether these competencies are best enhanced through formal academic courses or through other modes such as professional development programs, on the job training, or mentoring programs. Should consideration also be given to sourcing such teaching material from the available and relevant nonhealth environment? In addition, in some cases could current content at the postgraduate level be substituted, at least partly, by prerequisites at the undergraduate level? It could be said that both academics and health managers share a common but difficult challenge: whether to keep the status quo or dare to innovate in the face of changing health service practices.