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Background <p>The health workforce (HW) plays an important role in patient care, and in rural Australia its distribution varies substantially. This paper explores trends in Australia’s HW full-time equivalent (HW–FTE) rates and estimates the risk of HW attrition phenomena using data from local government areas (LGAs) during 2013–2021.</p> Methods <p>Trends and spatial analyses were used to understand HW–FTE rates for allied health professionals, medical practitioners, and nurses and midwives in four major types of Australian Statistical Geography Standard (ASGS) remoteness areas. The time-to-event modelling was used to identify HW retention times and probability of HW attrition, by remoteness areas and major states in Australia.</p> Results <p>On average the HW–FTE rate at the granular geo-spatial LGA level exhibits variation in trends between States, rurality, LGA and health professional groups over the study period. The increase in the HW–FTE rate over time for medical practitioners and allied health professionals is lower for outer regional, remote, and very remote Australia compared to inner regional Australia. The HW–FTE rate is also consistently lower for rural Australia compared to major cities irrespective of HW professions. The average HW retention time estimated for allied health was highest in major cities (5&#xa0;years), and lowest in outer regional areas (3&#xa0;years). States such as NSW and QLD had more than 4&#xa0;years of HW retention time for medical practitioners. For nurses and midwives, the average retention time was less than 3&#xa0;years for all states in Australia. There is variation in trends in HW–FTE rate between LGAs within and between States, including markedly contrasting trends between geographically adjacent LGAs.</p> Conclusions <p>Our results provide new insight into variation in HW availability, and trends in availability, between major health professional groupings between States, degrees of rurality and local government areas across Australia. This presents new opportunities for understanding and addressing factors that underly the variation in trends for the purpose of refining policy and programs that aim to address the persistent maldistribution and shortages in health worker availability between major cities and regional and remote parts of Australia.</p>

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Area remoteness and the distribution and attrition of the rural health workforce in Australia

  • 期刊论文

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  • 发表日期：

    2026年1月27日

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  • K. Shuvo Bakar,
  • Peter Radchenko,
  • Nam Ho-Nguyen,
  • Ellen McDonald,
  • Ross Bailie

摘要

Background

The health workforce (HW) plays an important role in patient care, and in rural Australia its distribution varies substantially. This paper explores trends in Australia’s HW full-time equivalent (HW–FTE) rates and estimates the risk of HW attrition phenomena using data from local government areas (LGAs) during 2013–2021.

Methods

Trends and spatial analyses were used to understand HW–FTE rates for allied health professionals, medical practitioners, and nurses and midwives in four major types of Australian Statistical Geography Standard (ASGS) remoteness areas. The time-to-event modelling was used to identify HW retention times and probability of HW attrition, by remoteness areas and major states in Australia.

Results

On average the HW–FTE rate at the granular geo-spatial LGA level exhibits variation in trends between States, rurality, LGA and health professional groups over the study period. The increase in the HW–FTE rate over time for medical practitioners and allied health professionals is lower for outer regional, remote, and very remote Australia compared to inner regional Australia. The HW–FTE rate is also consistently lower for rural Australia compared to major cities irrespective of HW professions. The average HW retention time estimated for allied health was highest in major cities (5 years), and lowest in outer regional areas (3 years). States such as NSW and QLD had more than 4 years of HW retention time for medical practitioners. For nurses and midwives, the average retention time was less than 3 years for all states in Australia. There is variation in trends in HW–FTE rate between LGAs within and between States, including markedly contrasting trends between geographically adjacent LGAs.

Conclusions

Our results provide new insight into variation in HW availability, and trends in availability, between major health professional groupings between States, degrees of rurality and local government areas across Australia. This presents new opportunities for understanding and addressing factors that underly the variation in trends for the purpose of refining policy and programs that aim to address the persistent maldistribution and shortages in health worker availability between major cities and regional and remote parts of Australia.