Employment in Dutch general hospitals was the equivalent of more than 125 full-time jobs (fte’s) in 2004. Management and administrative positions accounted for 21 thousand of these fte’s. These so-called overhead staff positions have grown at twice the rate of clinical staff positions.
More overhead, fewer support staff
Between 1997 and 2004 overhead staff (in terms of fte’s) have grown at twice the rate of total hospital staff. In spite of the many mergers of institutions in recent years, this has pushed up the share of overhead staff in the total number of full-time equivalents from 15 percent (1997) to 17 percent (2004). The explanation usually given for this in the care sector is the increase in administrative regulations for the accounting of health care.
The number of ancillary and support staff, on the other hand, fell by 2 percent in the period 1997–2004. Among other things, this decrease was the result of a drop in the number of available hospital beds of more than 10 percent. The combined share of overhead and ancillary and support staff remained constant in this period.
Staff composition in general hospitals
More doctors than nurses
The number of treating staff (doctors) rose twice as quickly as the number of nursing and caring staff in the period 1997–2004. The number of treating staff rose by 21 percent to more than 38 thousand, caring and nursing staff by 10 percent tot 43 thousand. This shift accompanies a fall in the average hospitalisation period from 9 days per admission in 1997, to just under 7 days in 2004.
Treating, nursing and caring staff in general hospitals
Relatively many overhead positions in hospitals
The percentage of overhead staff in hospitals is fairly high compared with nursing homes and care homes for the disabled. In 2004, for example, 17 of every 100 fte’s in general hospitals and 23 of every 100 fte’s in university hospitals were overhead positions. In nursing homes and care homes for the disabled this was 7 and 8 of 100 fte’s respectively.
An explanation for the higher percentage of overhead staff in hospitals is the higher patient turnover, and also the higher number of patients per bed and therefore more administrative work. In addition, the number of day treatment cases and out-patient treatments are also significant in hospitals.
Diane Confurius and Martin Boon