is physical rehabilitation need associated with the rehabilitation workforce supply? an ecological study across 35 high-income countries

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.