Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector (BMC Health Services Research)

Background: Recruiting and retaining health professions remains a high priority for health systemplanners. Different employment sectors may vary in their appeal to providers. We used theconcepts of inflow and stickiness to assess the relative attractiveness of sectors for physicaltherapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working ina sector who were not there the previous year. Stickiness was defined as the transitionprobability that a physical therapist will remain in a given employment sector year-to-year. Methods: A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primaryemployment sector was categorized as `hospital`, `community`, `long term care` (LTC) or`other.` Inflow and stickiness values were then calculated for each sector, and trends wereanalyzed. Results: There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolutegrowth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%.PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in thissector remaining year-to-year. The community and other employment sectors had stickinessvalues of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of73.4%. Conclusion: Among all employment sectors, LTC had highest inflow but lowest stickiness. Givenexpected increases in demand for services, understanding provider transitional probabilitiesand employment preferences may provide a useful policy and planning tool in developing asustainable health human resource base across all employment sectors.