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Physical Therapy Health Human Resource Ratios: A Comparative Analysis of the United States and Canada

MD Landry, PT, PhD, is Adjunct Assistant Professor, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and Assistant Professor, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Rehabilitation Sciences Building, 8th Floor, 160–500 University Ave, Toronto, Ontario, Canada M5G 1V7.
TC Ricketts, PhD, is Professor, Department of Health Policy and Administration, and Director, North Carolina Rural Health Research Program, Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
E Fraher, MPP, PhD Candidate, is Director, NC Health Professions Data System, Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
MC Verrier, PT, MSc, is Associate Professor, Department of Physical Therapy and Graduate Department of Rehabilitation Sciences, University of Toronto.

Address all correspondence to Dr Landry at: mike.landry{at}utoronto.ca

Background and Purpose: Health human resource (HHR) ratios are a measure of workforce supply and are expressed as a ratio of the number of health care practitioners to a subset of the population. Health human resource ratios for physical therapists have been described for Canada but have not been fully described for the United States. In this study, HHR ratios for physical therapists across the United States were estimated in order to conduct a comparative analysis of the United States and Canada.

Methods: National US Census Bureau data were linked to jurisdictional estimates of registered physical therapists to create HHR ratios at 3 time points: 1995, 1999, and 2005. These results then were compared with the results of a similar study conducted by the same authors in Canada.

Results: The national HHR ratio across the United States in 1995 was 3.8 per 10,000 people; the ratio increased to 4.3 in 1999 and then to 6.2 in 2005. The aggregated results indicated that HHR ratios across the United States increased by 61.3% between 1995 and 2005. In contrast, the rate of evolution of HHR ratios in Canada was lower, with an estimated growth of 11.6% between 1991 and 2005. Although there were wide variations across jurisdictions, the data indicated that HHR ratios across the United States increased more rapidly than overall population growth in 49 of 51 jurisdictions (96.1%). In contrast, in Canada, the increase in HHR ratios surpassed population growth in only 7 of 10 jurisdictions (70.0%).

Discussion and Conclusion: Despite their close proximity, there are differences between the United States and Canada in overall population and HHR ratio growth rates. Possible reasons for these differences and the policy implications of the findings of this study are explored in the context of forecasted growth in demand for health care and rehabilitation services.

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