Abstract
• Priority areas for targeting physiotherapy services in New Zealand are unknown
• Three-step floating catchment area method identifies physiotherapy spatial inequity
• Spatial accessibility for Māori, Pacific, high socioeconomic deprivation and rural
• New Zealand physiotherapy workforce is inequitably distributed for Māori and rural•Novel methods that can be built on for routine use in health service planning
Background: In Aotearoa New Zealand (NZ), physiotherapists are legislated first-contact practitioners yet physiotherapy services outside of limited public services have low subsidy rates or are entirely user-pays. The distribution of geographic accessibility of physiotherapy relative to population health need in this context is not known.
Objective: To examine NZ physiotherapy spatial accessibility at a high acuity level in relation to demographic indicators of health need (Māori or Pacific ethnicity, socioeconomic deprivation, rurality).
Methods: Using the distance-based 3-step floating catchment area (3SFCA) geospatial analysis methodology, location data for 5582 physiotherapists (92 % of the registered physiotherapists at March 2022) were integrated with 2018 NZ Census data to generate 'accessibility scores' (weighted practitioner: population ratio) for each Statistical Area 2. Population demographic characteristics were cross tabulated with accessibility scores and thematically mapped. Trends in relationships were explored statistically.
Results: Specific locations of inequity where health need is high, yet accessibility of physiotherapy is low (<0.94 to 9.06 per 10,000 population) were identified. Low physiotherapy accessibility was statistically associated with high proportion population Māori ethnicity and more rural location.
Conclusions: The methods can be built on to generate intelligence for developing and evaluating strategies to eliminate modifiable spatial inequities in physiotherapy care.