Supply shortages of the occupational therapy workforce in Italy: cross-regional and nationwide analysis against key benchmarks

Background Developing the Occupational Therapy (OT) workforce is key to supporting the growing global burden of disability. The OT workforce is underdeveloped in many countries, including high-income countries. Italy experiences significant gaps in the supply, training, and regional distribution of the OT workforce. However, no in-depth national and cross-regional analysis of the Italian OT workforce has been conducted to inform effective policy and resource planning. This study aims to (1) quantify the number of Italian OT personnel and compare numbers against national and international benchmarks, (2) identify regional workforce imbalances, and (3) identify national and regional gaps in undergraduate workforce training capacity. Methods Secondary, comparative analysis of OT personnel supply and undergraduate OT training capacity in Italy and its 20 regions was undertaken. Multi-sourced professional registration data was used to compute regional workforce-supply densities for 2024 and compared to international benchmarks. Ministry-based data was used to determine the number of available student places on OT undergraduate training programs in 2020–2024, compared to actual student uptake. Spearman’s rank-order examined the association between regional training capacity (i.e., density of training positions, averaged for the last five years) and the current workforce personnel density across the 20 regions. Results In 2024 Italy had 4.4 OTs per 100,000 people: 7.2 times lower than the European average and 17 times lower than the international recommendation. Substantive regional variations were noted: from 0.74 density in Sardinia to 20.72 in Trento-Bolzano. Yet, no Italian region met these European average (34.8–97.7% shortage) or international recommendations, with OT personnel shortages of between 72.3% and 99.0% evident. The gap between the actual and the required training capacity widened over time: from a 4.3% shortage in 2020 to a 50.4% shortage in 2025. The regional training capacity and regional workforce density were significantly correlated (estimate: 0.67; p = 0.002). Conclusions Italy experiences large OT workforce shortages with significant geographical inequities and widening disparities between undergraduate training needs and capacity. Both large and targeted investment which re-balances regional inequalities is critical to address Italy’s substantive undersupply and inequitable distribution of the OT workforce.