Geographic Accessibility to Pelvic Health Physiotherapy Services Across Ontario: A Geographic Information System Analysis

Abstract

Purpose: The purpose of this study was to explore the distribution and geographic accessibility of pelvic health physiotherapist services for females in Ontario across an urban–rural gradient. Method: A geographic information system-based observational study was conducted. Physiotherapists’ practice locations (supply) were obtained from the College of Physiotherapists of Ontario registrant pelvic health roster. Dissemination area centroids (demand) were calculated based on 2021 Statistics Canada census data for females in Ontario. Locations were geocoded and mapped, and an accessibility score was computed using an enhanced two-step floating catchment area method. A choropleth map was generated with accessibility scores, and results were stratified using an urban–rural gradient. Results: Geographic locations of 1172 pelvic health physiotherapists across Ontario were retrieved. The provincial average accessibility score was 1.84 pelvic health physiotherapists (PHPTs) per 10,000 females (range, min-max, 0–26.27 PHPTs). Access to a PHPT is more limited in rural areas and municipalities with weak to no metropolitan influence and higher in census metropolitan areas and larger urban centres. Conclusions: Regional disparities in accessibility to PHPT services for females in Ontario exist and should be considered in planning and policy development, particularly to enhance accessibility to females living in rural areas.