Abstract
Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.
Highlights
Despite efforts to more evenly distribute health professionals across Australia, rural and remote areas continue to face unequal access to healthcare services in comparison to their metropolitan counterparts [1]
A customised dataset was created by the Australian Bureau of Statistics (ABS) detailing the head counts and average hours worked for all three-digit Minor Groups and four-digit Unit Groups that included at least one of the identified six-digit Occupation codes by region, by gender and by level of employment participation for people who specified their workplace location as Tasmania in the 2011 and 2016 Census of Population and Housing datasets
2016, which corresponded to a 10.8% increase in full time equivalent (FTE) positions and a 7.6% growth in annual hours of service per capita (Table 1)
Summary
Despite efforts to more evenly distribute health professionals across Australia, rural and remote areas continue to face unequal access to healthcare services in comparison to their metropolitan counterparts [1]. Health workforce planning should provide such information, and yet traditional approaches have typically focused on a supply–demand model, with assessments made between the anticipated number of professionals needed within a community and the actual supply [2,3] Whilst this approach has helped identify potential gaps in service provision and the need for training pipelines to be established, it has fostered a siloed view of the healthcare workforce. The objective of this study was to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’
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