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Report From a National Survey Of Health Service Facilities for the National Review of Nursing Education 20012. Organisational Demographics2.1 Summary Institutions were asked to respond to several questions about their demographics. These included funding source (e.g. public or charitable); whether they were responding as a single facility, several facilities or an area health service; their principal service focus (acute care, maternity, paediatrics, mental health to name a few); the average bed numbers in their organisation; their postcode (to determine the State or Territory) and finally, whether they classified themselves as a metropolitan or non-metropolitan location. A total of 432 questionnaires were returned for analysis. All States were represented with no questionnaires identified (by postcode) as being from either the ACT or the Northern Territory. Twenty-nine respondents did not provide their postcode and appear as 'not stated' (see Table 1). It should be noted that NSW and Queensland are under-represented in the sample. There is an almost equal distribution between metropolitan and non-metropolitan responses across all States. Table 1 - Hospitals responding by state/territory (n = 432)
Institutions were asked to indicate whether they were public, private for-profit, charitable or private not-for-profit (Table 2) and this forms the basis on which much of the analysis has been undertaken. Table 2 - Hospitals responding by category (n = 432)
Table 2 indicates that public hospitals comprised 132 of the 432 responses (31%); 155 were private for-profit hospitals (36%); 49 were charitable institutions (11%) and 87 were private non-profit hospitals (20%). This information was not stated for 9 respondents. Public hospitals are under-represented in the sample (31%) while the private for-profit had the greatest proportion of responses (36%). Table 3 provides an analysis of responses by State and category. The public health facility category is under-represented in responses (particularly in Queensland and NSW) when compared to responses from the private for-profit category. Table 3 - Category of organisation by State (n = 432)
Health facilities were asked to identify whether they were classified as metropolitan or non-metropolitan. Figure 1 presents this data by category of facility. Figure 1 - Category of organisation by location (n = 423*)
* Responses where organisation category not stated are excluded from this figure. The greatest proportion of public institutions from whom responses were received were from the non-metropolitan areas. In contrast, more institutions from the metropolitan areas responded for the remaining three categories of institution. A better level of representation in the survey from the metropolitan based large public institutions would have strengthened the analysis given their history and level of involvement in undergraduate nursing education. As this was not so the profile of respondents must be taken into account when considering the results presented in this Report. Respondents were also asked to indicate the average bed numbers in their institution over the past year to determine institutional size. Many organisations appear to have provided data on the occasions of service. These responses have not been included and nor have those which reported bed numbers >500 as it seemed likely responses may have related to occasions of service rather than actual bed numbers. In addition, responses from area health services, multiple facilities, day-only or community care facilities have not been included in Table 4 as the information being sought related to individual organisational size. Table 4 - Bed numbers by category of organisation 4a Metropolitan and non-metropolitan institutions
4b Metropolitan institutions only
4c Non-metropolitan institutions only
*Numbers sum to 39 not 40 because one respondent did not indicate whether metropolitan or non-metropolitan Table 4 (a) indicates that there were very small organisations which responded across all categories (minimum 1 bed in the private for-profit to 10 in the public category). The mean number of beds in the metropolitan area (Table 4b) is larger than for the non-metropolitan (Table 4c) for all categories of institution, but note the large standard deviations. However when the medians are examined the same result is found except for the private for-profit category which has a median bed size larger in the non-metropolitan areas. Minimum and maximum bed numbers are larger for the public category in both the metropolitan and non-metropolitan areas than for the remaining three categories. Organisations were also asked to indicate their service focus (type of care provided) in their facility (acute care, maternity, paediatrics to name a few). Multiple responses to this question were possible and are presented in Table 5. Table 5 - Category of organisation and number of service foci
A total of 103 of the 432 respondents (24%) selected none of the areas of service focus listed on the survey. From Table 5, 59 public institutions responded that they provided one type of service focus (44.70%) while two indicated seven types of service focus, probably reflecting either a large institution or an area-wide response. Most respondents indicated their institutions represented a single type of care facility, particularly in categories other than the public category. Five institutions in the private non-profit sector indicated they represented three areas of service focus. Ninety-six single facility types were found in the private for-profit category indicating a limited range of service provision in each institution. Table 6 - Category of organisation by type of facility service focus
(Percentages are not provided because some institutions indicated multiple service foci.) When the health service focus is cross-tabulated with category of organisation in Table 6, the greatest proportion of hospitals were classified as generalist or acute care with nursing homes well represented. Of note are the 45 institutions in the public category which indicated a focus of community care and the large number of day only facilities which responded from the private for-profit sector. The service focus of 'Day only', 'Hostel' and 'Rehabilitation' were added based on responses to an open-ended question to nominate additional service foci. These respondents did not select any other service focus and would not otherwise have been represented by facility type in Table 4. 2.1 SummaryIn summary, a large number of small non-metropolitan institutions responded to the questionnaire as did many day only and community care institutions. Public institutions are under-represented in the sample of respondents and this must be considered in the results which follow because traditionally, this category of institution has been the largest participant in the provision of education for nurses. Under-representation was particularly apparent in New South Wales and Queensland. |
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