Mental Health, Justice Health, Alcohol and Drug Services, Canberra Health Services, Canberra, Australian Capital Territory, Australia.
College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Aust J Rural Health. 2024 Apr;32(2):332-342. doi: 10.1111/ajr.13092. Epub 2024 Feb 28.
There is a long standing and worsening shortage of psychiatrists in Australia particularly in rural areas. The majority of psychiatrists work in major cities.
To identify recent trends in the Australian rural psychiatrist workforce compared with the metropolitan workforce.
We descriptively analysed population-level data from the National Health Workforce Data Set (NHWDS), the Australian Institute of Health and Welfare (AIHW) and the Australian Bureau of Statistics (ABS). A descriptive analysis of the numbers (count) and gender of psychiatrists from 1995 to 2022 working in Australia was conducted. For the period 2013 to 2022, we analysed for rurality, gender, years' experience, hours worked, Medicare-subsidised services provided and proportions of Specialist International Medical Graduates (SIMG) by sex, with a focus on the rural workforce. For international comparison, psychiatrist numbers were obtained for other OECD countries. The number of psychiatrists working in Australia, as per NHWDS and AIHW, was quantified. We analysed trends in demographics, hours worked and rurality of psychiatrists working in Australia in a serial cross-sectional design.
Most psychiatrists are maldistributed to major cities, while outer regional and remote areas have few resident psychiatrists. Outer regional New South Wales (NSW) and South Australia (SA) have the lowest numbers of psychiatrists per capita. The full-time equivalent (FTE) of psychiatrists per 100 000 has increased from 12.6 in 2000 to 15.2 in 2022. However, the average hours worked by psychiatrists has declined. In total, available psychiatrist hours worked per 100 000 population has increased by 6.1% since the beginning of the millennium.
Rural areas in NSW and SA have the greatest shortage of psychiatrists. Specialist International Medical Graduates and females (43% of the overall workforce) are the predominant workforce in rural areas. Although Medicare-subsidised services per 1000 people have increased in rural areas, they remain lower than for those living in major cities.
There remains an acute shortage of psychiatrists in many regional and remote areas of Australia, with an increasing proportion of SIMGs and females working in these areas, in the context of future increased demand.
澳大利亚长期存在且日益严重的精神科医生短缺问题，尤其是在农村地区。大多数精神科医生在主要城市工作。
确定与大都市劳动力相比，澳大利亚农村精神科医生劳动力的近期趋势。
我们从国家卫生劳动力数据集（NHWDS）、澳大利亚卫生和福利研究所（AIHW）和澳大利亚统计局（ABS）中对人口水平数据进行描述性分析。对 1995 年至 2022 年在澳大利亚工作的精神科医生人数（计数）和性别进行描述性分析。对于 2013 年至 2022 年期间，我们分析了农村地区、性别、工作年限、工作时间、提供的医疗保险补贴服务以及按性别划分的专业国际医学毕业生（SIMG）的比例，重点是农村劳动力。为了国际比较，我们还获得了其他经合组织国家的精神科医生人数。根据 NHWDS 和 AIHW，我们量化了在澳大利亚工作的精神科医生人数。我们以串行横截面设计分析了澳大利亚精神科医生的人口统计学、工作时间和农村分布趋势。
大多数精神科医生分布不均，主要集中在大城市，而外围地区和偏远地区的常驻精神科医生较少。新南威尔士州（新州）和南澳大利亚州（南澳）的每万人精神科医生人数最少。每 10 万人的全职等效（FTE）精神科医生人数从 2000 年的 12.6 人增加到 2022 年的 15.2 人。然而，精神科医生的平均工作时间有所下降。自本世纪初以来，每 10 万人口的可用精神科医生工作时间增加了 6.1%。
新州和南澳的农村地区精神科医生短缺最为严重。专业国际医学毕业生和女性（占劳动力总数的 43%）是农村地区的主要劳动力。尽管农村地区每 1000 人获得的医疗保险补贴服务有所增加，但仍低于主要城市的水平。
澳大利亚许多地区和偏远地区仍然严重缺乏精神科医生，在未来需求增加的情况下，越来越多的 SIMG 和女性在这些地区工作。
