Wu Guosong, Sapiro Natalie, Martens Riley, Harmon Megan, Risling Tracie, Eastwood Cathy
Cape Breton University, Sydney, Nova Scotia, Canada
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
BMJ Open. 2025 Jun 6;15(6):e092114. doi: 10.1136/bmjopen-2024-092114.
To examine longitudinal trends and identify key indicators of nursing workforce shortages across Canadian provinces and territories using publicly available data.
Retrospective ecological study.
Primary and secondary care in Canada. National data were extracted from Statistics Canada and the Canadian Institute for Health Information (CIHI) between 2015 and 2022 at the provincial and territorial levels.
The study included registered nurses and registered psychiatric nurses employed in the Canadian healthcare system. Licensed practical nurses and nurse practitioners were excluded. Territories with missing data were excluded from the analysis.
The primary outcome was nursing workforce shortage, assessed in relation to potential indicators, including the nurse-to-population ratio, job vacancy rate and annual costs of overtime work, using structural equation modelling (SEM).
The Canadian nursing workforce grew by 8.0%, with the nurse-to-population ratio increasing from 11.08 to 12.13 per 1000 population. Job vacancies rose by 6.4% (95% CI: 6.29 to 6.51%), overtime hours increased by 13.09 million (95% CI: 10.28 to 15.87) and yearly overtime costs rose by 0.78 billion CAD (95% CI: 0.64 to 0.92). SEM revealed significant associations between workforce shortage and the nurse-to-population ratio (standardised β=0.863, 95% CI: 0.942 to 0.975), job vacancy rate (β=0.958, 95% CI: 0.927 to 0.990) and yearly overtime costs (β=0.983, 95% CI: 0.967 to 0.999). Predicted shortage scores were lower before 2020 but increased significantly after 2020, potentially reflecting the impact of COVID-19 pandemic.
Despite growth in the nursing workforce, increasing job vacancies, overtime hours and costs highlight persistent shortages. Monitoring these indicators is essential for effective workforce planning and sustainable healthcare delivery.
利用公开数据研究加拿大各省和地区护理劳动力短缺的纵向趋势并确定关键指标。
回顾性生态研究。
加拿大的初级和二级护理。2015年至2022年期间，从加拿大统计局和加拿大卫生信息研究所（CIHI）提取省级和地区级的国家数据。
该研究纳入了受雇于加拿大医疗系统的注册护士和注册精神科护士。排除了执业护士和执业护师。分析中排除了数据缺失的地区。
主要结局是护理劳动力短缺，使用结构方程模型（SEM），根据潜在指标进行评估，包括护士与人口比例、职位空缺率和年度加班成本。
加拿大护理劳动力增长了8.0%，护士与人口比例从每1000人口11.08人增加到12.13人。职位空缺率上升了6.4%（95%置信区间：6.29至6.51%），加班时长增加了1309万小时（95%置信区间：1028至1587），年度加班成本增加了7.8亿加元（95%置信区间：6.4至9.2）。结构方程模型显示劳动力短缺与护士与人口比例（标准化β=+0.863，95%置信区间：0.942至0.975）、职位空缺率（β=+0.958，95%置信区间：0.927至0.990）和年度加班成本（β=+0.983，95%置信区间：0.967至0.999）之间存在显著关联。预测的短缺得分在2020年之前较低，但在2020年之后显著增加，这可能反映了新冠疫情的影响。
尽管护理劳动力有所增长，但职位空缺、加班时长和成本的增加凸显了持续存在的短缺问题。监测这些指标对于有效的劳动力规划和可持续的医疗服务提供至关重要。
