Rehabilitation workforce descriptors: a scoping review

Abstract

Background: A comprehensive, accurate description of workforce capacity is important for health service planning, to ensure that health services meet local needs. In many low- to middle-income countries, the government's service planning ability is barred by the lack of accurate and/or comprehensively-described workforce data. In these low-resource settings, lack of appropriate planning leads to limited or no access to rehabilitation services. Variability in the definitions and scope of rehabilitation professionals further complicates the understanding of rehabilitation services and how it should be planned and delivered. Another challenge to describing the primary rehabilitation workforce capacity, is the lack of standardised and agreed-upon global metrics. These inconsistencies highlight the need for a comprehensive understanding of current practices, which can offer guidance to countries wishing to describe their rehabilitation workforce. This study aimed to scope the range of descriptors and metrics used to describe the rehabilitation workforce and to compare the workforce across countries that used similar descriptors in published reports.

Methods: A scoping review was conducted according to the five-step framework first developed by Arksey and O'Malley. The review included a broad search of literature regarding the rehabilitation workforce and how countries quantify and describe the rehabilitation workforce.

Results: Nineteen studies on rehabilitation workforce capacity were identified. All but one (a cross-sectional study) were database reviews. The main descriptors and indicators used to describe the rehabilitation workforce capacity were profession type, age, gender, distributions between urban/rural, level of care, and private/public sectors, absolute count totals, and population-adjusted ratios.

Conclusion: This scoping review provided an overview of descriptors and indicators used to describe the rehabilitation workforce capacity internationally. The study is a first step towards developing standardised descriptors and metrics to quantify the rehabilitation workforce capacity, that will allow for comparison between different settings.

Trial registration: This scoping review protocol has been registered with the Open Science Framework (http://osf.10/7h6xz).

Keywords: Descriptors; Indicators; Rehabilitation; Supply; Workforce.

Fig. 1

PRISMA flowchart showing the selection of studies for inclusion in the scoping review

Fig. 2

Comparison of population-adjusted ratios for physiotherapists. Legend: USA-United States of America

Fig. 3

Comparison of population-adjusted ratios for occupational therapists. Legend: USA-United States of America and SA-South Africa

Fig. 4

Comparison of population-adjusted ratios for speech therapy and audiology. Legend: USA-the United States of America, SA-South Africa, AU-audiology and ST-speech therapy

Fig. 5

Physiotherapy and occupational therapy combined number per 10 000 population per country. Legend: USA-United States of America