Data Methods and Comments
Data Methods. HPRC obtains licensing databases for health professionals from the licensing boards and then edits those databases to remove out-of-state and inactive records, and, to correct data entry mistakes when possible. Various levels of editing are done on the data depending on the licensure data type being edited - some licensure board databases being more problematic than others, especially with the following fields:
County Field. Since many health professionals practice in a county different from the one in which they live, HPRC prefers to report data by "County of Practice," as this gives a more accurate picture of where health professionals are actually providing care, and which counties may have shortages. However, many licensing boards only report a "Mailing Address." And, for those professions for which both Mailing and Practice addresses are collected, there are usually a substantial number of licensees who do not report their Practice address. In those cases, a health professional's Practice county field is determined by his/her mailing address. This can create a problem when trying to determine the supply and distribution of professionals by county. In addition, addresses are sometimes difficult to geocode with Geographic Information Systems (GIS) programs. For example, sometimes a hospital's name is provided by the licensee as his/her Practice address, rather than the hospital's street address. Post Office Boxes and Route Numbers are also difficult to geocode. And, a number of Practice addresses are often incomplete; for example, the City name may be provided but not a street address or zip code, and, since there are many cities in Texas that are partially located in more than one county, this may yield inaccurate results. For example, a licensee who gives only the City of Dallas as his/her practice address is likely to be coded to Dallas County, when that person may actually be practicing in Denton or Collin County.
Supply and distribution studies may also be misleading because many health professionals practice their profession in more than one county. The recording of multiple practice sites is not allowed by most state licensing boards.
Physician Data. The data on physicians in all tables excludes those physicians classified as federal (Military, Veterans Administration, Public Health Service), and residents and fellows. These exclusions generally comprise about 9% to 10% of the direct patient care physician workforce. Thus, our physician supply totals may differ slightly from the supply totals reported by the Texas Medical Board, since they do not exclude these physicians from their reports. And, only physicians with a Texas practice address (or Texas mailing address if the practice address is not available) are included in our supply tables.
Dentist Data. The supply numbers reported in our tables exclude federal, military and dental resident records. Historically, the only practice types included in the supply tables were the "primary care dentists" (classified in our tables as General Dentists): general dentistry, pediatric dentistry and dental public health; excluded were specialized practice types such as endodontics, oral/maxi. surgery, oral pathology, orthodontics, peridontics and prosthodontics. Beginning in 2005, another table has been available each year for All Dentists, which includes those specialties excluded above. Also, only those dentists with a Texas mailing address are included on the supply tables.
Trends Analysis. Data collection and processing methods often change over time. Various Activity Status codes are added or removed by the licensing boards, and, at times a determination may be made to begin to count licensees with a particular License or Employment Status code which may not have been counted in previous years. Conversely, at times a determination is made to cease to include licensees with a particular License or Employment Status code. HPRC works closely with the licensing boards and other health professional associations, and it is often at their suggestion that these changes are made by HPRC. Although these changes result in more accurate data at that time, they also skew the trend lines when doing an analysis of supply trends over a period of time when different collection methods were used. HPRC endeavors to footnote, on the health professions supply webpages, any changes that are made of this nature.
Population Data. HPRC uses Texas population data to calculate supply ratios. In most cases, the population data come from the Texas State Data Center (TxSDC). TxSDC regularly updates their population projections; therefore, the population numbers used by HPRC on a supply table for a particular year (for example 2002) may not match the TSDC population estimate for that same year (2002) at a later date (for example in 2008). HPRC uses the population numbers available at any given time and does not revise older tables to reflect new population estimates. In addition, TxSDC has multiple population numbers for any given area, based on various Migration Scenarios and other factors. For more information on how population projections and estimates are determined, please visit the Center for Health Statistic's website at http://www.dshs.state.tx.us/chs/chs_faqs.shtm#PopProjEst.
Note: External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These sites may also not be accessible to people with disabilities.