The Distribution of Physiotherapists in Ontario: Understanding the Market Drivers

Abstract

Purpose: To understand the factors that affect the distribution of physiotherapists in Ontario by examining three potential influences in the multi-payer physiotherapy (PT) market: population need, critical mass (related to academic health science centres [AHSCs]), and market forces. Methods: Physiotherapist density and distribution were calculated from 2003 and 2005 College of Physiotherapists of Ontario registration data. Physiotherapists' workplaces were classified as not-for-profit (NFP) hospitals, other NFP, or for-profit (FP), and their locations were classified by census division (CD) types (cities and counties). Results: Physiotherapist density varied significantly and distribution was neither uniformly responsive to population need, nor driven primarily by market forces. The largest factor was an AHSC in a CD; physiotherapists locate disproportionately in NFP hospitals in AHSCs rather than in the growing FP sector. Conclusions: While some patterns can be discerned in the distribution and densities of physiotherapists across Ontario, further work needs to be done to identify why population need and market forces appear to be less influential, and why CDs with AHSCs are so attractive to physiotherapists. With this additional information, it may be possible to identify ways to influence uneven distribution in the future.Key Words: delivery of health care market; health manpower; policy; demography. RÉ SUMÉObjectif : Comprendre les facteurs qui affectent la ré partition des physiothé rapeutes en Ontario en analysant trois influences potentielles dans le marché de la physiothé rapie à payeurs multiples, soit les besoins de la population, la masse critique (lié e aux centres universitaires de sciences de la santé ) et les forces du marché . Mé thode : La ré partition et la densité de physiothé rapeutes ont é té calculé es pour les anné es 2003 et 2005 à partir des donné es d'inscription à l'Ordre des physiothé rapeutes de l'Ontario. Les milieux de travail des physiothé rapeutes ont é té classé s par caté gories : hô pitaux à but non lucratif (HBNL) ou autres milieux à but non lucratif (BNL) ou à but lucratif (BL). Leurs emplacements ont ensuite é té classé s par types de division du recensement (villes ou comté s). Ré sultats : La densité de physiothé rapeutes varie considé rablement et leur ré partition n'é tait ni unilaté ralement dé finie en fonction des besoins de la population, ni motivé e principalement par les forces du marché . Le plus important facteur é tait un centre universitaire de sciences de la santé dans une division du recensement; les physiothé rapeutes sont pré sents de maniè re disproportionné e dans les hô pitaux à but non lucratif de tels centres universitaires au lieu d'ê tre dans le secteur en croissance des cliniques à but lucratif. Conclusions : Bien que certains modè les peuvent ê tre dé gagé s dans la ré partition et la densité des physiothé rapeutes en Ontario, d'autres recherches devront ê tre entreprises afin de pré ciser pourquoi les besoins de la population et les forc...

A profile of physiotherapy supply in Ireland

“…Results from both New Zealand and Canada (the provinces of Saskatchewan and Ontario), highlight that physiotherapy supply is also unevenly distributed in other countries [21][22][23]. This paper's results highlight that if the aim of treating more conditions in the community is to be realised, the inequalities in supply of primary care services, such as those for physiotherapists found in this paper, need to be rectified.…”

Mapping the Physiotherapy Profession in Saskatchewan: Examining Rural versus Urban Practice Patterns

“…Furthermore, location and distribution patterns of PT service delivery beyond primary place of employment have yet to be studied. 4,10,11 Holyoke and colleagues 10 examined factors that affect the distribution of physiotherapists in Ontario by investigating potential influences of public, private, or quasi-public PT payers. Although they provided information about general PT services distribution, they did not explicitly examine differences between rural and urban geographical distribution.…”

“…Although they provided information about general PT services distribution, they did not explicitly examine differences between rural and urban geographical distribution. 10 A national picture of PT workforce characteristics and distribution is provided by the Canadian Institute for Health Information's (CIHI's) annual report. 12 CIHI collects and compiles information on supply, demographics, education, employment, geography, and mobility of physiotherapists in Canada, but CIHI data on service delivery locations are presented as dichotomous variables (rural vs. urban) and thus do not show relative rurality, that is, the degree to which a community is influenced by neighbouring urban centres.…”

Variations in demand and provision for publicly funded outpatient musculoskeletal physiotherapy services across Quebec, Canada

“…Our results indicate a higher density of clinicians per population in the 6 least densely populated regions (regions 02, 08, 09, 10, 11, and 17) compared to some of the most densely populated regions (regions 03, 06, 13, and 14). This is a surprising finding considering that studies from other Canadian provinces rather found a higher density of physiotherapists in areas with academic centres compared to rural and remote areas . A possible explanation for this contrasting result is that the survey data we used focused solely on publicly funded outpatient PT workforce in hospitals.…”

“…Wide variations in the density of physiotherapists were also found in other provinces, ranging approximately between 10 and 90 physiotherapists per 100 000 in Saskatchewan and between around 20 and 80 physiotherapists per 100 000 population in Ontario . Another study conducted in Ontario indicates that the density of physiotherapists working in not‐for‐profit hospitals per 100 000 population in 2005 ranged from 0.6 to 37.5, with a provincial average of 15.1. In the United States, the density of physiotherapists per 100 000 population varied from 34.9 to 109.8 between jurisdictions in 2005.…”