. 2023 Apr 27;5(1):e000407.

doi: 10.1136/bmjno-2023-000407. eCollection 2023.

Modelling accessibility of adult neurology care in Australia, 2020-2034

Steve Simpson-Yap^{1

2

3}, Federico Frascoli⁴, Lucinda Harrison¹, Charles Malpas^{1

5}, James Burrell⁶, Nicholas Child⁷, Lauren P Giles⁸, Christian Lueck⁹, Merrilee Needham¹⁰, Benjamin Tsang¹¹, Tomas Kalincik^{1

5}

Affiliations

¹ CORe, Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
² Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC, Australia.
³ Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
⁴ Department of Mathematics Computing, and Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria, Australia.
⁵ Neuroimmunology Centre, Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶ Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁷ Neurology North Shore, Auckland, New Zealand.
⁸ Department of Neurology, Launceston General Hospital, Launceston, Tasmania, Australia.
⁹ School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
¹⁰ Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia.
¹¹ Neurology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia.

PMID: 37144009
PMCID: PMC10151858
DOI: 10.1136/bmjno-2023-000407

Modelling accessibility of adult neurology care in Australia, 2020-2034

Steve Simpson-Yap et al. BMJ Neurol Open. 2023.

. 2023 Apr 27;5(1):e000407.

doi: 10.1136/bmjno-2023-000407. eCollection 2023.

Authors

Affiliations

¹ CORe, Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
² Neuroepidemiology Unit, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC, Australia.
³ Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
⁴ Department of Mathematics Computing, and Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria, Australia.
⁵ Neuroimmunology Centre, Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶ Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁷ Neurology North Shore, Auckland, New Zealand.
⁸ Department of Neurology, Launceston General Hospital, Launceston, Tasmania, Australia.
⁹ School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
¹⁰ Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia.
¹¹ Neurology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia.

PMID: 37144009
PMCID: PMC10151858
DOI: 10.1136/bmjno-2023-000407

Erratum in

Correction: Modelling accessibility of adult neurology care in Australia, 2020-2034.
[No authors listed] [No authors listed] BMJ Neurol Open. 2023 May 22;5(1):e000407corr1. doi: 10.1136/bmjno-2023-000407corr1. eCollection 2023. BMJ Neurol Open. 2023. PMID: 37265547 Free PMC article.

Abstract

Introduction: In 2015/2016, annual national expenditure on neurological conditions exceeded $A3 billion. However, a comprehensive study of the Australian neurological workforce and supply/demand dynamics has not previously been undertaken.

Methods: Current neurological workforce was defined using neurologist survey and other sources. Workforce supply modelling used ordinary differential equations to simulate neurologist influx and attrition. Demand for neurology care was estimated by reference to literature regarding incidence and prevalence of selected conditions. Differences in supply versus demand for neurological workforce were calculated. Potential interventions to increase workforce were simulated and effects on supply versus demand estimated.

Results: Modelling of the workforce from 2020 to 2034 predicted an increase in neurologist number from 620 to 89. We estimated a 2034 capacity of 638 024 Initial and 1 269 112 Review encounters annually, and deficits against demand estimated as 197 137 and 881 755, respectively. These deficits were proportionately greater in regional Australia, which has 31% of Australia's population (Australian Bureau of Statistics) but is served by only 4.1% of its neurologists as determined by our 2020 survey of Australia and New Zealand Association of Neurologists members. Nationally, simulated additions to the neurology workforce had some effect on the review encounter supply deficit (37.4%), but in Regional Australia, this impact was only 17.2%.

Interpretation: Modelling of the neurologist workforce in Australia for 2020-2034 demonstrates a significant shortfall of supply relative to current and projected demand. Interventions to increase neurologist workforce may attenuate this shortfall but will not eliminate it. Thus, additional interventions are needed, including improved efficiency and additional use of support staff.

Keywords: epidemiology; neuroepidemiology; statistics.

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Conflict of interest statement

Competing interests: CM has received conference travel support and/or speaker fees from Merck, Novartis and Biogen. He has received research support from the National Health and Medical Research Council, Multiple Sclerosis Research Australia, The University of Melbourne, The Royal Melbourne Hospital Neuroscience Foundation, and Dementia Australia. MN: I have received honoraria and consultancy fees from Abcuro, Sanofi-Genyzme, Roche, Biogen and CSL-BehringTomas Kalincik has served on scientific advisory boards for Roche, Sanofi-Genzyme, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Sanofi-Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Sanofi-Genzyme, Teva, BioCSL and Merck and received research support from Biogen. Other authors have no conflicts of interest to report.

Figures

**Figure 1**
Neurologist career progression model used for estimating and projecting neurologist numbers.

**Figure 2**
Ordinary differential equations used for neurologist number projections.

**Figure 3**
Projected numbers of neurologists in Australia, 2020–2034, including with simulated addition of extra 5, 10 and 20 neurologists per year over 2022–2031.

**Figure 4**
Projected numbers of neurologists in regional Australia, 2020–2034, including with simulated addition over 2022–2031 of an extra 2, 5 and 10 neurologists per year.

**Figure 5**
Estimation of supply and demand of neurological care in Australia, 2020–2034, updated prevalence and incidence-based demand estimates, preferential capacity allocation to review encounters.

**Figure 6**
Estimation of supply and demand of neurological care in regional Australia, 2020–2034, updated incidence and prevalence-based estimates of demand, preferential capacity allocation to review encounters.

See this image and copyright information in PMC

References

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Modelling accessibility of adult neurology care in Australia, 2020-2034

Affiliations

Modelling accessibility of adult neurology care in Australia, 2020-2034

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources