The precarious supply of physical therapists across Canada: exploring national trends in health human resources (1991 to 2005)

National population data were combined with provincial databases of registered physical therapists in order to estimate the HHR ratio in 2005, and to establish trends between 1991 and 2005.The national HHR ratio was 4.3 PTs per 10,000 population in 1991, which increased to 5.0 by 2000. In 2005, the HHR ratios varied widely across jurisdictions; however, we estimate that the national average dropped to 4.8 PTs per 10,000. Although the trend in HHR between 1991 and 2005 suggests positive growth of 11.6%, we have found negative growth of 4.0% in the latter 5-years of this study period.Demand for rehabilitation services is projected to escalate in the next decade. Identifying benchmarks or targets regarding the optimal number of PTs, along with other health professionals working within inter professional teams, is necessary to establish a stable supply of health providers to meet the emerging rehabilitation and mobility needs of an aging and increasingly complex Canadian population.Health Human Resources (HHR) has emerged as a critical factor in health policy planning across Canada [1-5], and within the international community [6-8]. At the federal level, the Pan-Canadian Health Human Resource Strategy acknowledged that, "Appropriate planning and management of HHR are key to developing a health-care workforce that has the right number and mix of health professionals to serve Canadians in all regions of the country" [9]. All provincial and territorial jurisdictions appear to have developed HHR strategies aimed at ensuring that appropriate levels of health providers are in place when and where services are most required [10].An overall measure of supply within a workforce is the HHR ratio, which is generally expressed as a ratio in the absolute number of health professionals to a sub-set of the population [11]. As noted by Ricketts [12], the origins of the HHR ratio for use in workforce policy can be traced back to work done in the United States where researchers in the 1