Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Northern Territory of Australia

摘要: International evidence suggests that a key to improving health and attaining more equitable outcomes for disadvantaged populations is system with strong primary care sector. Longstanding problems workforce supply turnover in remote Aboriginal communities the Northern Territory (NT), Australia, jeopardise delivery effort overcome substantial gaps this population. This research describes temporal changes government-operated clinics NT through period which there has been increase funding. Descriptive Markov-switching dynamic regression analysis of Government Department Health payroll financial data resident 54 clinics, 2004–2015. The included registered Remote Area Nurses Midwives (nurses), Practitioners (AHPs) staff administrative logistic roles. Main outcome measures: total number unique employees per year; average annual headcounts; full-time equivalent (FTE) positions; agency employed nurse FTE estimates; high low state estimates. Overall increases occurred between 2004 2015, especially positions. Supply nurses AHPs increased from an 2.6 3.2 clinic, although declined since 2010. Each year almost twice as many individual government-employed or are required each position. Following funding increases, some doubled their nursing AHP achieved relative stability supply. However, most staffing much smaller extent not at all, typically experiencing “fading” following initial associated greater funding, frequently cycling periods higher lower levels. 2015 have affected by continuing very AHPs, compounded recent declines Despite resourcing, imperative remains implement robust service models better support retention staff.