Is Physical Rehabilitation Need Associated With the Rehabilitation Workforce Supply? An Ecological Study Across 35 High-Income Countries

Abstract

Background: To determine whether population-adjusted rates of physical rehabilitation need (ie, disability-related epidemiological data) are associated with the workforce supply (ie, combined rates of practicing physical therapists (PTs) and occupational therapists (OTs) per 10 000 population) across high-income countries (HICs), adjusted for socio-demographic and economic covariates. Methods: This is a cross-national ecological study. Hierarchical, multiple linear regressions analyzed current international data across 35 HICs using: current PTs and OTs supply data obtained from the international professional federations (outcome variable); needs data obtained from the Global Burden of Disease 2017 (GBD 2017); and finally relevant socio-demographic variables and supply-side covariates extracted from the World Bank, GBD 2017, the supply data sources, and the Global Health Expenditure Database. Results: The PTs and OTs per capita varied greatly across the 35 HICs, differing by as much as 40-fold. Denmark had the greatest supply per capita. Physical rehabilitation need was not a significant, independent predictor of workforce supply regardless of the multiple regression model used (P >.10). In the final model, after Bonferroni correction, 3 covariates were significant, independent predictors of the supply variable: gross national income (GNI) per capita and the current health expenditure in % of gross domestic product (GDP) were positive factors for workforce supply, while population size was a negative factor (all P <.01). Conclusion: PT and OT workforce supply is highly variable across HICs. This variability is not accounted for by an indicator of population need but rather by financial indicators and population size.

Limitations and Recommendations for Advancing the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis of the Literature

“…Finally, international coalitions are needed to underpin concerted occupational therapy workforce developments. While relevant across countries of varying income levels, international cooperation seems especially required for the scale-up of occupational therapy education and for workforce development in LMICs [ 69 ] and possibly in other countries where the occupational therapy profession and workforce seem under-developed (e.g., in Italy the proportion of occupational therapists per physical therapists is 2–98% when, for example, Israel nearly has a 50–50% distribution [ 81 ]). Cooperation can occur through LMICs within a region for scale and mutual learning, through the involvement of institutions and experts from higher-income countries, and both at the same time [ 82 , 83 ].…”

Global health workforce research: Comparative analyses of the scientific publication trends in PubMed

“…avoiding the detection of non-relevant articles in terms of scope). This iterative calibration process was conducted by one research author (TJ) with both bibliometric 21,[27][28][29]37 and HRH expertise, 42,43,[50][51][52] using random screenings of up to 100 articles, and observing which MeSH term(s) dictated the inclusion of any non-relevant articles retrieved by the evolving search strategy. With subsequent refinements toward a more precise search strategy (e.g.…”

Accurate Prediction of Knee Angles during Open-Chain Rehabilitation Exercises Using a Wearable Array of Nanocomposite Stretch Sensors

“…There is a proportional need for post-operative physical therapy. However, recent estimates show a decreasing ratio of physical therapists (PTs) per unit of population [ 6 , 7 ], partly due to burnout and career dissatisfaction [ 8 ] among PTs. The imbalance between the rising number of patients requiring rehabilitation and a decreasing workforce is expected to grow.…”