The rehabilitation workforce in Brazil

Abstract

Abstract Background: Demand for rehabilitation services has been increasing due to the increase of individuals with functional impairment. It is essential to know the supply of the rehabilitation workforce to better plan the health system to meet the health needs of the population. Objective: To investigate the spatial and temporal distribution of physical therapists, speech therapists, psychologists and occupational therapists across the levels of care within the Brazilian Unified Health System and its regions. Method: This is an ecological time series study on the supply of rehabilitation professionals. Data were obtained from the National Register of Health Establishments from 2007 to 2020. The density of professionals was calculated per 10,000 inhabitants per year for Brazil and its five regions. The Joinpoint regression model was used to analyze the temporal trends of the density of professionals, considering the 95% confidence interval. Results: In 2020, the most notable concentrations of psychologists, speech therapists, and occupational therapists in Brazil were observed in the domain of Specialized Health Care, with densities of 0.60, 0.20, and 0.16 professionals per 10,000 inhabitants, respectively. Conversely, the highest density of physical therapists was found in the context of Hospital Health Care, with a density of 1.19 professionals per 10,000 inhabitants. Notably, variations in professional distribution across different regions were apparent. Primary Health Care exhibited the highest density of professionals in the Northeast region, while the Southern region accounted for the highest densities in all professional categories within Specialized Health Care. The southeast region demonstrated the largest workforce within Hospital Health Care. A considerable increase in the availability of professionals was observed across all categories, with the most substantial growth seen in the occupational therapy sector within hospital care (AAPC: 30.8), despite its low density. Conclusion: The implementation of public health policies has played a significant role in the expansion of the rehabilitation workforce at all three levels of care in Brazil and its various regions from 2007 to 2020. Consequently, regional disparities and densities of professionals have emerged, resembling patterns observed in low-income countries.