Using staffing ratios for workforce planning: evidence on nine allied health professions

A systematic literature search using relevant MeSH headings of business, medical and allied health databases and relevant grey literature for the period 2000-2008 was undertaken.Twelve articles were identified which described the use of workforce ratios in allied health services. Only one of these was a staffing ratio linked to clinical outcomes. The most comprehensive measures were identified in rehabilitation medicine.The evidence for use of staffing ratios for allied health practitioners is scarce and lags behind the fields of nursing and medicine.Health care worldwide is a large and expensive industry for which there are high consumer expectations. As health care increasingly relies on expensive technologies and drugs, governments are under mounting pressure to find ways to contain costs. Managing staff costs has emerged as a major area of focus [1,2]. It has become apparent that there are service over-laps [3,4], and that staff allocation must be evidence-based [5,6] and focused on the needs of the population serviced rather than continuing with traditional areas and modes of service [7-9]. The Australian Productivity Commission recently identified under-utilisation of the professional competencies of staff as an area of concern for the Australian health workforce [10].When introducing new services and reviewing current service delivery models, managers must make decisions on what constitutes appropriate levels of staffing. Different methods such as ratios; where staff are provided in a set ratio per measure such as bed numbers or population; and staffing according to patient acuity (for acute care services) are methods used in health care services for determining appropriate staff levels. While models of this type have been used successfully with nursing [11-13], and medical specialty professions [14], what constitutes appropriate levels of staffing for allied health professionals (AHPs) is less clear.An Australian study [15,16] reviewed a number of workload c