Abstract
Background:
Despite rural populations experiencing higher disability and disease burdens, access to allied health professionals remains disproportionately poor. Addressing this issue requires a clear understanding of workforce distribution, which is crucial for effective planning and the development of strategies to bolster rural allied health services.
Method:
We spatially analysed all available Australian occupational therapy (OT) registration data from 2013 to 2021. This data was compared against census data from 2011, 2016, and 2021 for total population and key populations likely to require OT (e.g. disability and chronic disease populations) across all Modified Monash Model (MMM) levels. We examined work and demographic characteristics of the OT workforce to construct profiles across each MMM level and identify trends in service types and formal leadership roles.
Results:
Despite an overall increase of over 10,000 OTs since 2013, this analysis revealed the maldistribution of OTs to urban areas remained unchanged. Maldistribution worsened when compared to key client populations including people with disabilities and chronic disease. Nearly all growth in OT hours resulted from private practice increases, with public service hours per 1,000 population remaining consistent across the nine years. Private practice hours increased significantly in metropolitan areas (MMM1), regional centres (MMM2), and large rural towns (MMM3), but fell with remoteness. While public service hours increased somewhat in remote areas (MMM6-7) over the timeframe, they actually decreased in rural spaces (MMM4-5) and this was not countered with sufficient increases in private practice to provide equity with metropolitan areas.
Further, we identified that formalised OT leadership roles such as administration and research, along with specialized scopes of practice (e.g., neurology), were predominantly concentrated in urban centres. However, paediatrics and disability scopes of practice, both of which have had significant funding increases through personalisation schemes, showed more balanced distribution.
Conclusion:
Our spatial analysis highlights the persistent maldistribution of the OT workforce across different geographical areas and job roles which has remained unchanged in nine years. Under current growth rates, only regional centres will reach parity with metropolitan areas, but will take over 8 years to reach parity. All other MMM levels will continue to fall behind. This will be likely worsened by the centring of leadership and specialised scope of practice roles in metropolitan areas. Significant changes to policy and education practices are required to address allied health workforce shortages in rural and remote places, particularly considering funding approaches to allow private practice entry to rural markets.
Despite rural populations experiencing higher disability and disease burdens, access to allied health professionals remains disproportionately poor. Addressing this issue requires a clear understanding of workforce distribution, which is crucial for effective planning and the development of strategies to bolster rural allied health services.
Method:
We spatially analysed all available Australian occupational therapy (OT) registration data from 2013 to 2021. This data was compared against census data from 2011, 2016, and 2021 for total population and key populations likely to require OT (e.g. disability and chronic disease populations) across all Modified Monash Model (MMM) levels. We examined work and demographic characteristics of the OT workforce to construct profiles across each MMM level and identify trends in service types and formal leadership roles.
Results:
Despite an overall increase of over 10,000 OTs since 2013, this analysis revealed the maldistribution of OTs to urban areas remained unchanged. Maldistribution worsened when compared to key client populations including people with disabilities and chronic disease. Nearly all growth in OT hours resulted from private practice increases, with public service hours per 1,000 population remaining consistent across the nine years. Private practice hours increased significantly in metropolitan areas (MMM1), regional centres (MMM2), and large rural towns (MMM3), but fell with remoteness. While public service hours increased somewhat in remote areas (MMM6-7) over the timeframe, they actually decreased in rural spaces (MMM4-5) and this was not countered with sufficient increases in private practice to provide equity with metropolitan areas.
Further, we identified that formalised OT leadership roles such as administration and research, along with specialized scopes of practice (e.g., neurology), were predominantly concentrated in urban centres. However, paediatrics and disability scopes of practice, both of which have had significant funding increases through personalisation schemes, showed more balanced distribution.
Conclusion:
Our spatial analysis highlights the persistent maldistribution of the OT workforce across different geographical areas and job roles which has remained unchanged in nine years. Under current growth rates, only regional centres will reach parity with metropolitan areas, but will take over 8 years to reach parity. All other MMM levels will continue to fall behind. This will be likely worsened by the centring of leadership and specialised scope of practice roles in metropolitan areas. Significant changes to policy and education practices are required to address allied health workforce shortages in rural and remote places, particularly considering funding approaches to allow private practice entry to rural markets.
Original language | English |
---|---|
Publication status | Published - 16 Sept 2024 |
Event | 17th National Rural Health Conference - Perth Convention & Exhibition Centre, Perth, Australia Duration: 16 Jun 2024 → 18 Jun 2024 https://www.ruralhealth.org.au/17nrhc/ |
Conference
Conference | 17th National Rural Health Conference |
---|---|
Abbreviated title | Imagine, inspire & innovate. |
Country/Territory | Australia |
City | Perth |
Period | 16/06/24 → 18/06/24 |
Other | The National Rural Health Conference is the pre‑eminent event in Australia for information and inspiration about rural and remote health and wellbeing. |
Internet address |