Abstract
BackgroundRecruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year.MethodsA longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed.ResultsThere were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%.ConclusionAmong all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.
Highlights
Recruiting and retaining health professions remains a high priority for health system planners
We examined physical therapy employment sectors based on four primary logics: first, the physical therapy workforce in Canada has not been well documented in the literature; second, the demand for physical therapy and rehabilitation services has been reported to be increasing in the province [15,17,23,25,26]; third, “PTs” are among the largest provider group within rehabilitation [27,28,29]; and fourth, funding streams and delivery models in which physical therapists practice have experienced much change over the last decade [30,31]
The hospital sector appeared to be the sector with the lowest growth, but remained a relatively attractive employment sector due to the ability to retain a fairly consistent physical therapy workforce year-to-year
Summary
Recruiting and retaining health professions remains a high priority for health system planners. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. The delivery of health care services relies on an appropriate and sustainable health human resource base. Health professionals practice and contribute across a care continuum, and a priority of health system policy and decision makers is to ensure stability among the workforce so Similar to many other countries, health human resource (HHR) policy and planning is a priority for health systems managers and planners across Canada [8,9,10,11,12,13]. The public policy arguments used to justify this shift often include cost savings, appropriateness of providing community-based services closer to where individuals and their families live, and the evolution of services that can be feasibly provided in the community [21]
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