Research Publications

For 25 years, Healthforce Center at UCSF has led the development and success of the next generation of California’s health leaders. Through its most longstanding initiative — the CHCF Health Care Leadership Program, funded by the California Health Care Foundation — Healthforce has designed a…

California’s San Joaquin Valley faces a critical health workforce shortage that threatens access to care, particularly in its rural and low-income communities. This case study examines how locally led initiatives are addressing these shortages by building culturally responsive, regionally rooted…

Telehealth may redress rural health care shortages in the United States and improve related rural health disparities. However, following the expansion of telehealth related to the COVID-19 pandemic, telehealth use has been lower among rural populations compared to urban populations. Certain…

Telehealth may help ameliorate rural healthcare shortages and related negative health outcomes for rural populations in the United States. However, telehealth utilization has been lower among rural than urban populations. Patient experiences are an essential determinant of healthcare utilization…

People with dementia have complex medical, functional, and social needs and experience highly variable care quality and out- comes across the U.S. health care system. Community-based physicians, nurse practitioners, and physician assistants serve crit- ical roles in diagnosing and managing dementia…

The evidence is clear: California needs a diverse health care workforce to meet the needs of an increasingly diverse population. This policy brief provides evidence-based policy recommendations. An accompanying issue brief explores what we know about the diversity of California’s licensed…

The evidence is clear: California needs a diverse health care workforce to meet the needs of an increasingly diverse population. This issue brief explores what we know about the diversity of California’s licensed health care workforce, what works to increase the diversity of health care…

Health workforce planning and development is a collaborative process requiring the engagement of multiple stakeholders with expertise across different domains, including health care systems, health professions training and education, and policymaking. This collaborative process also requires a…

Despite California’s population becoming increasingly diverse, the current health workforce has yet to reflect these demographic shifts; however, Nurse Practitioners (NPs) play a critical role in addressing gaps in primary care access across the state. In 2023, California implemented new…

This annotated bibliography aims to highlight seminal articles, reports, editorials, and other key pieces of literature that explore AI’s impact on the health workforce in a rapidly evolving landscape. It will be updated over time to reflect new developments.

Personal Care Aides (PCAs) play a vital role in the direct care workforce, providing essential support to older adults and individuals with disabilities or serious illnesses. PCAs, working alongside home health aides, make up the largest occupational group in the U.S. workforce, helping individuals…

California has a well-documented health workforce shortage, especially in rural areas. Accelerated education programs are one of the many approaches being employed to reduce shortages by shortening the educational pathway and increasing the production of qualified health care providers.This issue…

Improving access to midwifery care has been identified as a strategy to address shortages of reproductive health clinicians and ensure person-centered, equitable care. This article describes findings from a new survey of licensed midwives (LMs) in California, who enter the profession without a…

Standardizing and improving the treatment that Medicare beneficiaries living with dementia receive requires understanding the settings where they are receiving care, the types of clinicians providing that care, and whether clinicians recognize the diagnosis of dementia in their encounters with…

Each year, long-term acute care hospitals (LTACHs) care for over 70,000 individuals with complex and serious illness requiring prolonged inpatient care for weeks or months following a short-stay hospitalization. While LTACHs are most distinct from other post-acute care settings for their…

Physicians, especially in primary care, likely faced substantial revenue loss during the COVID-19 pandemic due to decreases in patient volume and deferred healthcare utilization. While studies have focused on projections and limited surveys, the impact of the pandemic on physician revenue is…

Highlights: The U.S. cesarean birth rate was 32.4% in 2023 and continues to increase each year. Avoiding morbidity and mortality risk associated with cesarean birth is critical. RN staffing during labor and birth is linked to cesarean rates. RN staffing aligned with national standards…

Background. American Indian/Alaska Native (AI/AN), Black (B), and Hispanic/Latino (H/L) people are underrepresented in dentistry, yet disproportionately constitute the safety-net dental workforce. We examined the relationship between serving as safety-net providers (SNPs) and self-reported income…

More than 83 million people in the United States live in primary care shortage areas. As the US healthcare system faces a contracting primary care physician workforce, advanced practice providers are playing an increasingly important role in the delivery of primary care services. In parallel,…

As the largest occupational group in the United States (combined with home health aides), personal care aides (PCAs) provide care for millions of Americans. Despite the size of the workforce, PCAs still struggle with unaddressed job quality challenges – inadequate training being primary among them…

Access to dental care for millions of Californians is tied to coverage by California’s Medicaid (Medi-Cal) Dental insurance program. While child dental coverage is federally mandated, adult dental coverage is optional. In 2009, adult dental coverage was mostly eliminated but was partially…

The Community Health Representative (CHR) Program was established by Congress in 1968 to provide an outreach component meeting the specific healthcare needs of tribes and tribal communities. This program predates the official recognition of non-tribal Community Health Workers (CHWs) by the American…

Medicaid Home and community-based services (HCBS) and home-based clinical care (i.e., Medicare home health care) aim to support independence and well-being in the community, especially for older adults living with disability and complex health conditions, such as dementia. Many older adults receive…

Improving care coordination for people living with dementia (PLWD) requires understanding of the types of clinicians delivering care and the settings in which they practice. We identified all beneficiaries with dementia in traditional Medicare in 2019. We used the Medicare Carrier file — i.e…

Advancing health equity requires acknowledging and attending to inequities within the health policy and services research (HSPR) workforce. Although HSPR racial and ethnic diversity has been increasing, the profession still has considerable unfinished work: in 2021, Black, Hispanic, and Indigenous…

Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to…

This report provides California policymakers with up-to-date information about the state’s physician workforce and the pipeline of trainees in the state’s medical schools and graduate medical education (GME) programs, often referred to as residency programs. This report focuses on the five…

Healthforce Center at UCSF and Health Career Connection hosted this informational webinar for health workforce planners interested in learning more about the available public data relevant to regional health workforce analyses and planning.

Clinician burnout remains prevalent, exacerbated by factors such as inadequate staffing, a lack of organizational support, devaluation, and poor interpersonal relations. Amidst provider shortages, the nurse practitioner (NP) workforce is expanding, paralleling high rates of burnout. This study,…

Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints…