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Kruger, Estie, Irosha Perera, and Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia." Australian Journal of Primary Health 16, no. 4 (2010): 291. http://dx.doi.org/10.1071/py10028.
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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
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Burke, David, Ayse Burke, and Jacqueline Huber. "Psychogeriatric SOS (services-on-screen) – a unique e-health model of psychogeriatric rural and remote outreach." International Psychogeriatrics 27, no. 11 (July 29, 2015): 1751–54. http://dx.doi.org/10.1017/s1041610215001131.
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Mental health service delivery to rural and remote communities can be significantly impeded by the tyranny of distance. In Australia, rural and remote mental health services are characterized by limited resources stretched across geographically large and socio-economically disadvantaged regions (Inderet al., 2012; Thomaset al., 2012). Internationally, rural and remote area mental health workforce shortages are common, especially in relation to specialist mental health services for older people (McCarthyet al., 2012; Bascuet al., 2012).
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Pong, RW, M. DesMeules, D. Heng, C. Lagacé, JR Guernsey, A. Kazanjian, D. Manuel, et al. "Patterns of Health Services Utilization in Rural Canada." Chronic Diseases and Injuries in Canada 31, supplement 1 (September 2011): 1–36. http://dx.doi.org/10.24095/hpcdp.31.s1.01.
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Canadians value ease of access to their health services. Although many studies have focused on accessibility to health services in Canada, few have examined rural-urban differences in this aspect, particularly from a national perspective. Yet disparities in access to health services exist between rural and urban populations, as do the challenges of delivering health care to more remote areas or to those with small populations. “Canada’s Rural Communities: Understanding Rural Health and Its Determinants” is a three-year research project co-funded by the Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC). It involves investigators from the Public Health Agency of Canada, the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University, and other researchers. The first publication of the research project was How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants;Footnote 1a1a this, the second publication, is a descriptive analysis of the utilization patterns of a broad range of health services by rural residents compared to their urban counterparts.
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Osadolor, Obehi O., Aisosa J. Osadolor, Owens O. Osadolor, Eunice Enabulele, Ezi A. Akaji, and Davidson E. Odiowaya. "Access to health services and health inequalities in remote and rural areas." Janaki Medical College Journal of Medical Science 10, no. 2 (August 28, 2022): 70–74. http://dx.doi.org/10.3126/jmcjms.v10i2.47868.
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ABSTRACT
Access to health care includes the availability, accessibility, awareness, accommodation or adequacy, affordability, and acceptability of health services. Scarce health facilities, long distances to health facilities, shortages of medicine, level of poverty, shortages of doctors, dentists, and other health professionals, level of education and knowledge among populace on orthodox treatment practices are factors that affects access to health care. Level of awareness among the populace of preventive and curative services offered by health facilities, absence of health insurance, and inability to afford the cost of health services are obstacles limiting rural people from recognizing and achieving the health and social related Sustainable Development Goals (SDGs), that requires that access to good quality healthcare is improved significantly in rural areas and under-served population.
Health inequalities exist both between and within developed and developing countries, both between and within urban, semi-urban and rural areas. Health inequalities are determined by various socioeconomic factors: such as age, sex, race, ethnicity, education, income, social status, unemployment and place of residence of the population. The factors that give rise to, and worsen, inequalities in health are multidimensional. Interventions in addressing health inequalities would involve economic policies, strategic health planning, health education on avoidable risk factors for poor health, use of telemedicine/tele dentistry, and reduction of unmet healthcare needs among various population groups. Other interventions are poverty eradication interventions especially in remote and rural areas, healthcare financing through budgetary allocation, and improving access to health service through universal health coverage, with an organized and efficient health system.
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Moffatt, Jennifer J., and Diann S. Eley. "The reported benefits of telehealth for rural Australians." Australian Health Review 34, no. 3 (2010): 276. http://dx.doi.org/10.1071/ah09794.
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Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.
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Regmi, Kiran, and Kapil Amgain. "Needs, Challenges, and Opportunities in Establishing and Maintaining Medical Education in Karnali Academy of Health Sciences (KAHS)." Journal of Karnali Academy of Health Sciences 2, no. 2 (August 6, 2019): 79–80. http://dx.doi.org/10.3126/jkahs.v2i2.25165.
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The constitution of Nepal (2015), article 35 (Right relating to health) stated that every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services. According to the World Bank report (collection of development indicators compiled from various official sources, 2016), Nepal has 81% rural and remote populations. Health service delivery is a complex reality for the rural and remote populations and faces enormous challenges. One of them is insufficient and uneven distribution of health workforce. The World Health Report concluded that "the severity of the health workforce crisis is in some of the world's poorest countries, of which 6 are in South East Asia out of 57 countries having critical shortages of health workforce."1Even after 13 years situation has not much improved. Nepal faces a critical shortage of trained health workforce, especially in rural and remote areas. Health workforce recruitment and retention in rural and remote areas is a difficult task challenged by the preferences and migration of health workforce to urban areas in country, or even abroad for better life and professional development.2 One of the most effective strategies for health workforce recruitment and retention for rural and remote areas could be that of establishing and maintaining Medical Education in rural and remote areas decentralized from urban academic medical centers.
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Jennings, Natasha, Grainne Lowe, and Kathleen Tori. "Nurse practitioner locums: a plausible solution for augmenting health care access for rural communities." Australian Journal of Primary Health 27, no. 1 (2021): 1. http://dx.doi.org/10.1071/py20103.
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With 2020 being designated the Year of the Nurse and Midwife, it is opportune to acknowledge and recognise the role that nurses undertake in primary care environments. Nurses and midwives play a pivotal role in the delivery of high-quality health care, particularly in geographically challenged areas of Australia, where they may be the only provider of care within their communities. Rural and remote health services require strategic planning to develop and implement solutions responsive to the challenges of rural and remote communities. Maintenance of health services in rural and remote areas is a challenge, crucial to the equity of health outcomes for these communities. Many small communities rely on visiting medical officers to provide the on-call care to facility services, including emergency departments, urgent care centres, acute wards and aged care facilities. It is increasingly difficult to maintain the current rural workforce models, particularly the provision of after-hours ‘on-call’ care necessary in these communities. An alternative model of health care service delivery staffed by nurse practitioners (NP) is one proposed solution. NPs are educated, skilled and proven in their ability to provide an after-hours or on-call service to meet the expectations of rural and remote communities. Achievement of high-quality health care that is cost-efficient, safe and demonstrates improved patient outcomes has been reported in NP-led health care delivery impact evaluations. The value of an NP locum service model is the provision of a transparent, reliable service delivering consistent, equitable and efficient health care to rural and remote communities.
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Owen, Cathy, Christopher Tennant, Deslee Jessie, Michael Jones, and Valerie Rutherford. "A Model for Clinical and Educational Psychiatric Service Delivery in Remote Communities." Australian & New Zealand Journal of Psychiatry 33, no. 3 (June 1999): 372–78. http://dx.doi.org/10.1046/j.1440-1614.1999.00578.x.
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Objective: A model of intermittent psychiatric service provision to rural and remote New South Wales communities by metropolitan psychiatrists and mental health professionals has been evaluated. The services provided included peer support to lone mental health and generic health workers, direct psychiatric care to clients in their own environment and skills development education sessions to general health staff and other professionals affiliated with health care (e.g. police and ambulance officers). Method: There were 10 visits of teams made up of a psychiatrist and another mental health professional to six rural and remote locations. Outcomes of the services delivered were examined including clinical services and teaching skills training sessions. Indirect outcome measures included changes to Pharmaceutical Benefits Scheme prescription patterns in areas serviced and data regarding transfer of clients for psychiatric care in regional centres. Difficulties in evaluation are discussed. Results: The feasibility of intermittent service provision was demonstrated. Education packages were well received and a positive change in workers' attitudes toward mental health practice was found. Conclusion: Intermittent psychiatric services in remote settings add value to health care delivery particularly when dovetailed with skills-based education sessions.
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Nicholson, Laura Anne. "Rural mental health." Advances in Psychiatric Treatment 14, no. 4 (July 2008): 302–11. http://dx.doi.org/10.1192/apt.bp.107.005009.
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A significant proportion of people live and work in rural areas, and rural mental health is important wherever psychiatry is practised. There are inherent difficulties in conducting rural research, due in part to the lack of an agreed definition of rurality. Mental health is probably better in rural areas, with the exception of suicide, which remains highest in male rural residents. A number of aspects of rural life (such as the rural community, social networks, problems with access, and social exclusion) may all have particular implications for people with mental health problems. Further issues such as the effect of rural culture on help-seeking for mental illness, anonymity in small rural communities and stigma may further affect the recognition, treatment and maintenance of mental health problems for people in rural areas. Providing mental health services to remote and rural locations may be challenging.
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Hanna, Liz. "Support Funding for Australian Rural and Remote Health Workforce: A Medical - Nursing Mismatch." Australian Journal of Primary Health 7, no. 1 (2001): 9. http://dx.doi.org/10.1071/py01002.
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Successive Australian federal governments have introduced numerous strategies aimed at reducing the differentials in health status between rural and remote populations and their metropolitan counterparts. Foremost among these strategies have been those focused on increasing the numbers of medical practitioners in rural and remote areas (Australian Institute of Health and Welfare, 1998a). The paper challenges the prioritisation of this strategy, identified as a "planning priority" by the Commonwealth government. The 1999-2000 Federal Budget allocated $171 million to "significantly improve access to services in rural and remote areas of Australia and to strengthen the rural workforce". Nurses provide 90% of the health services to these populations yet receive only 0.9% of funding in direct role specific support. This systematic neglect of nursing services results in high turnover as nurses desert their posts, frustrated by lack of organisational support, and subsequent inability to provide adequate care in the difficult circumstances in which they must function. Interruptions to clinical health care provision and health promotion activities diminish health enhancement opportunities for the communities with demonstrated high levels of need (Australian Institute of Health and Welfare [AIHW], 1999; Commonwealth Department of Health & Aged Care, 2000; Kreger, 1991; NSW Health Department, 1998).
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Ryan, Ven-Nice, Stephen Stathis, Anthony C. Smith, Denisse Best, and Richard Wootton. "Telemedicine for rural and remote child and youth mental health services." Journal of Telemedicine and Telecare 11, no. 2_suppl (December 2005): 76–78. http://dx.doi.org/10.1258/135763305775124902.
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Bell, Pam, and Trish Buckley. "Conference review —Research issues in rural and remote area health services." Collegian 3, no. 4 (January 1996): 45–46. http://dx.doi.org/10.1016/s1322-7696(08)60197-3.
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Longman, Jo, Jennifer M. Pilcher, Deborah A. Donoghue, Margaret Rolfe, Sue V. Kildea, Sue Kruske, Jeremy J. N. Oats, Geoffrey G. Morgan, and Lesley M. Barclay. "Identifying maternity services in public hospitals in rural and remote Australia." Australian Health Review 38, no. 3 (2014): 337. http://dx.doi.org/10.1071/ah13188.
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Objective This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25 000 people across Australia, and presents the findings of this process. Methods Health departments and the national government’s websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. Results In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. Conclusions The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised. What is known about the topic? Australian birthing services have previously been identified for hospitals with 50 or more births a year. Less is known about public hospitals with fewer than 50 births a year or those with only antenatal and postnatal services, particularly in rural and remote locations, or how maternity services information may be identified from publicly available sources. What does this paper add? This paper describes the process and challenges of identifying maternity services in rural and remote public hospitals serving towns of between 1000 and 25 000, and presents the findings of this process. What are the implications for practitioners? Nationally accessible, reliable and comparable information is important for health planners, policy makers and health practitioners. This paper provides useful information on the variations in the capability and location of maternity services across Australia. Opportunities exist for consistent collection, collation and reporting of maternity services across rural and remote Australia. This will ensure quality and safety of services, contribute to policy review, support the development and maintenance of service networks, and assist in planning services and expenditure, as well as in the identification of problems. It is therefore key to providing equitable services across the country.
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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.
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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.
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Bryant, Lia, Bridget Garnham, Deirdre Tedmanson, and Sophie Diamandi. "Tele-social work and mental health in rural and remote communities in Australia." International Social Work 61, no. 1 (November 27, 2015): 143–55. http://dx.doi.org/10.1177/0020872815606794.
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Rural and remote communities often have complex and diverse mental health needs and inadequate mental health services and infrastructure. Information and communication technologies (ICTs) provide an array of potentially innovative and cost-effective means for connecting rural and remote communities to specialist mental health practitioners, services, and supports, irrespective of physical location. However, despite this potential, a review of Australian and international literature reveals that ICT has not attained widespread uptake into social work practice or implementation in rural communities. This article reviews the social work literature on ICT, draws on research on tele-psychology and tele-education, and provides suggestions on how to enhance engagement with ICT by social workers to implement and provide mental health services and supports tailored to community values, needs, and preferences that are commensurate with the values of the social work profession.
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Sutarsa, I. Nyoman, Rosny Kasim, Ben Steward, Suzanne Bain-Donohue, Claudia Slimings, Sally Hall Dykgraaf, and Amanda Barnard. "Do General Practitioners in a Visiting Medical Officer Arrangement Improve the Perceived Quality of Care of Rural and Remote Patients? A Qualitative Study in Australia." Healthcare 10, no. 6 (June 4, 2022): 1045. http://dx.doi.org/10.3390/healthcare10061045.
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Background: In rural and remote Australia, general practitioners (GPs) provide care across the continuum from primary to secondary care, often in Visiting Medical Officer (VMO) arrangements with a local hospital. However, little is known about the role of GP-VMOs in improving the perceived quality of care and health outcomes for rural and remote communities. Methods: We collected qualitative data from three GP-VMOs (all aged >55 years) and 10 patients (all aged over 65 years) in three local health districts of New South Wales, Australia. Thirteen in-depth interviews were conducted between October 2020 and February 2021. We employed thematic analysis to identify key roles of GP-VMOs in improving the perceived quality of care and health outcomes of rural and remote patients. Results: Our study advances the current understanding regarding the role of GP-VMOs in improving the perceived quality of services and health outcomes of rural and remote patients. Key roles of GP-VMOs in improving the perceived quality of care include promoting the continuity of care and integrated health services, cultivating trust from local communities, and enhancing the satisfaction of patients. Conclusions: GP-VMOs work across primary and secondary care creating better linkages and promoting the continuity of care for rural and remote communities. Employing GP-VMOs in rural hospitals enables the knowledge and sensitivity gained from their ongoing interactions with patients in primary care to be effectively utilised in the delivery of hospital care.
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Islam, Md Irteja, Claire O’Neill, Hibah Kolur, Sharif Bagnulo, Richard Colbran, and Alexandra Martiniuk. "Patient-Reported Experiences and Satisfaction with Rural Outreach Clinics in New South Wales, Australia: A Cross-Sectional Study." Healthcare 10, no. 8 (July 26, 2022): 1391. http://dx.doi.org/10.3390/healthcare10081391.
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Introduction: Many studies have been conducted on how physicians view outreach health services, yet few have explored how rural patients view these services. This study aimed to examine the patient experience and satisfaction with outreach health services in rural NSW, Australia and the factors associated with satisfaction. Methods: A cross-sectional study was conducted among patients who visited outreach health services between December 2020 and February 2021 across rural and remote New South Wales, Australia. Data on patient satisfaction were collected using a validated questionnaire. Both bivariate (chi-squared test) and multivariate analyses (logistic regression) were performed to identify the factors associated with the outcome variable (patient satisfaction). Results: A total of 207 participants were included in the study. The mean age of respondents was 58.6 years, and 50.2% were men. Ninety-three percent of all participants were satisfied with the outreach health services. Respectful behaviours of the outreach healthcare practitioners were significantly associated with the higher patient satisfaction attending outreach clinics. Conclusions: The current study demonstrated a high level of patient satisfaction regarding outreach health services in rural and remote NSW, Australia. Further, our study findings showed the importance of collecting data about patient satisfaction to strengthen outreach service quality.
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Curtis, Katy. "Including Infants: An Inter-Agency Model for Parent–Infant Mental Health and Well-Being in Rural Regions." Children Australia 37, no. 3 (August 9, 2012): 90–93. http://dx.doi.org/10.1017/cha.2012.26.
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There are well-recognised and articulated difficulties in the provision of health services to communities in rural and remote areas. These difficulties encompass practicalities and geography, economics and politics, as well as the personal and professional. This article describes a multi-level model developed by a group of regional services to address the mental health and well-being needs of infants and small children of rural and remote families, utilising existing resources creatively and collaboratively. The model draws on understandings from attachment theory about the nature and needs of humans as relational beings.
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Han, Gil-Soo, Julie Mahnken, and Sally Belcher. "More rural and Aboriginal students for health related university courses - are we making progress?" Australian Health Review 26, no. 2 (2003): 73. http://dx.doi.org/10.1071/ah030073.
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The shortage of health professionals in rural and remote areas has been a serious concern. Rural healthprofessionals are constantly leaving for urban practice. The training and recruitment of health professionals whomay be prepared to serve rural communities for a lengthy period is a challenge if a nation is committed to theprovision of equitable health services to its rural population.
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Taylor, Selina M., Alice Cairns, and Beverley D. Glass. "Expanded practice for rural community pharmacy: what are we waiting for?" International Journal of Pharmacy Practice 30, no. 1 (November 15, 2021): 86–88. http://dx.doi.org/10.1093/ijpp/riab072.
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Abstract Objective To synthesise stakeholder (consumer, pharmacist and health professional) perspectives of expanded pharmacy practice in rural and remote community pharmacy. Methods Comparison of perspectives of stakeholder groups identified by four studies has highlighted the expected outcomes and anticipated barriers to expanded pharmacy practice. Aligning the studies has identified priority areas of health for which pharmacists may be able to provide expanded service delivery. Key findings Expanded pharmacy services are supported by consumers, pharmacists and health professionals and are expected to improve health outcomes for rural and remote populations. Barriers will need to be overcome for expanded services to be sustainable in the future. Conclusion The pharmacy profession will need to undertake a paradigm shift to professional practice and work towards this should begin to reduce the health inequality for rural populations.
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Lessing, Kate, and Ilse Blignault. "Mental health telemedicine programmes in Australia." Journal of Telemedicine and Telecare 7, no. 6 (December 1, 2001): 317–23. http://dx.doi.org/10.1258/1357633011936949.
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A national survey of mental health telemedicine programmes was conducted and data collected on their catchment areas, organizational structure, equipment, clinical and non-clinical activity, and use by populations who traditionally have been poorly served by mental health services in Australia. Of 25 programmes surveyed, information was obtained for 23. Sixteen programmes had dealt with a total of 526 clients during the preceding three months. Of these, 397 (75%) were resident in rural or remote locations at the time of consultation. Thirty-seven (7%) were Aboriginals or Torres Strait Islanders. Only 19 (4%) were migrants from non-English-speaking backgrounds. The programmes provided both direct clinical and secondary support services. Overall, the number of videoconferencing sessions devoted to clinical activity was low, the average being 123 sessions of direct clinical care per programme per year. Videoconferencing was also used for professional education, peer support, professional supervision, administration and linking families. The results of the study suggest that telehealth can increase access to mental health services for people in rural and remote areas, particularly those who have hitherto been poorly served by mental health services in Australia.
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Carter-Snell, Catherine, Sonya Jakubec, and Barbara Hagen. "Collaboration with Rural and Remote Communities to Improve Sexual Assault Services." Journal of Community Health 45, no. 2 (October 1, 2019): 377–87. http://dx.doi.org/10.1007/s10900-019-00744-4.
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Carey, Timothy A. "Prioritizing impact to improve health services and reduce inequities in rural, remote and very remote locations." JBI Database of Systematic Reviews and Implementation Reports 17, no. 9 (September 2019): 1729–30. http://dx.doi.org/10.11124/jbisrir-d-19-00274.
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Jelinek, G. A., T. J. Weiland, C. Mackinlay, N. Hill, and M. F. Gerdtz. "Perceived Differences in the Management of Mental Health Patients in Remote and Rural Australia and Strategies for Improvement: Findings from a National Qualitative Study of Emergency Clinicians." Emergency Medicine International 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/965027.
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Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved.Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian emergency departments (EDs), stratified to represent states and territories and rural or metropolitan location. Content analysis of responses developed themes and sub-themes.Results. Of 39 doctors and 32 nurses responding to email invitation, 20 doctors and 16 nurses were interviewed. Major themes were resources/environment, staff and patient issues. Clinicians noted lack of access in rural areas to psychiatric support services, especially alcohol and drug services, limited referral options, and a lack of knowledge, understanding and acceptance of mental health issues. The clinicians suggested resource, education and guideline improvements, wanting better access to mental health experts in rural areas, better support networks and visiting specialist coverage, and educational courses tailored to the needs of rural clinicians.Conclusion. Clinicians managing mental health patients in rural and remote Australian EDs lack resources, support services and referral capacity, and access to appropriate education and training. Improvements would better enable access to support and referral services, and educational opportunities.
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Kavanagh, Bianca E., Hannah Beks, Vincent L. Versace, Shae E. Quirk, and Lana J. Williams. "Exploring the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia: A scoping review protocol." PLOS ONE 17, no. 12 (December 9, 2022): e0278606. http://dx.doi.org/10.1371/journal.pone.0278606.
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Introduction Australians from regional, rural, and remote areas face diverse and complex challenges in accessing and utilising mental health services. Previous research has pointed to a range of individual, community, structural, and systemic barriers at play, however, limited literature has synthesised the knowledge on this topic. Parallel to this, information on the facilitators to accessing and utilising mental health services for this group is not well documented. This protocol describes the methodology to undertake a scoping review, which aims to explore the barriers and facilitators associated with accessing and utilising mental health services in regional, rural, and remote Australia. In addition, the scoping review aims to geographically map the identified barriers and facilitators. Methods This protocol is guided by Arksey and O’Malley’s methodological framework. A search strategy will be developed and implemented to identify relevant peer-reviewed and grey literature. Studies will be included if they report on the barriers and/or facilitators associated with accessing and/or utilising mental health services in regional, rural, and remote Australia. Two reviewers will independently screen the data at the title/abstract and full-text stage. One reviewer will extract the relevant data using a predetermined charting form and a second reviewer will validate the included data. A Geographical Information System program will be used to map the location of the studies; locations will be stratified according to the Modified Monash Model and relationships between barriers and facilitators will be analysed. Key findings will be presented in a narrative account and in text, tables, and maps. Discussion This scoping review will provide a contemporary account on the barriers and facilitators to accessing and utilising mental health services for regional, rural, and remote Australians. It is anticipated that the results of this scoping review will have national policy relevance and may be useful to healthcare providers.
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Bourke, Sharon L., Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, and Linda Jones. "Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia." Online Journal of Rural Nursing and Health Care 21, no. 1 (May 4, 2021): 67–84. http://dx.doi.org/10.14574/ojrnhc.v21i1.652.
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Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care.
Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia.
Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.
Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision.
Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes.
Keywords: rural and remote, health access, mental health issues, social determinants
DOI: https://doi.org/10.14574/ojrnhc.v21i1.652
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Emerson, Philip, Naomi Dodds, David R. Green, and Jan O. Jansen. "Geographical access to critical care services in Scotland." Journal of the Intensive Care Society 19, no. 1 (July 13, 2017): 6–14. http://dx.doi.org/10.1177/1751143717714948.
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Background Critical illness requires specialist and timely management. The aim of this study was to create a geographic accessibility profile of the Scottish population to emergency departments and intensive care units. Methods This was a descriptive, geographical analysis of population access to ‘intermediate’ and ‘definitive’ critical care services in Scotland. Access was defined by the number of people able to reach services within 45 to 60 min, by road and by helicopter. Access was analysed by health board, rurality and as a country using freely available geographically referenced population data. Results Ninety-six percent of the population reside within a 45-min drive of the nearest intermediate critical care facility, and 94% of the population live within a 45-min ambulance drive time to the nearest intensive care unit. By helicopter, these figures were 95% and 91%, respectively. Some health boards had no access to definitive critical care services within 45 min via helicopter or road. Very remote small towns and very remote rural areas had poorer access than less remote and rural regions.
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Fernandes, Brian, Edward R. Scheffer Cliff, and Amelia Chowdhury. "Achieving self-sufficiency: training Australia’s future medical workforce." Australian Health Review 42, no. 6 (2018): 640. http://dx.doi.org/10.1071/ah17019.
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There is an oversupply of Australian junior doctors, but significant training bottlenecks are developing, and geographical maldistribution in rural and remote areas remains. Last year, the Federal Minister for Immigration rejected a Department of Health recommendation for the removal of 41 health roles from the Skilled Occupation List after concerns that rural and regional communities would be left without access to medical services in areas currently serviced by international medical graduates. In an effort to achieve workforce self-sufficiency, Australia must ensure access to high-quality vocational training places in rural and regional settings while managing immigration of overseas-trained health professionals.
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Stenlund, Diana. "Videoconferencing and Dietitian Services: In Rural Ontario Communities." Canadian Journal of Dietetic Practice and Research 73, no. 4 (December 2012): 176–80. http://dx.doi.org/10.3148/73.4.2012.176.
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Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.
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Jones, Debra, Lindy McAllister, Robert Dyson, and David Lyle. "Service-learning partnerships: Features that promote transformational and sustainable rural and remote health partnerships and services." Australian Journal of Rural Health 26, no. 2 (November 6, 2017): 80–85. http://dx.doi.org/10.1111/ajr.12381.
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Burmeister, Oliver K., and Edwina Marks. "Rural and remote communities, technology and mental health recovery." Journal of Information, Communication and Ethics in Society 14, no. 2 (May 9, 2016): 170–81. http://dx.doi.org/10.1108/jices-10-2015-0033.
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Purpose This study aims to explore how health informatics can underpin the successful delivery of recovery-orientated healthcare, in rural and remote regions, to achieve better mental health outcomes. Recovery is an extremely social process that involves being with others and reconnecting with the world. Design/methodology/approach An interpretivist study involving 27 clinicians and 13 clients sought to determine how future expenditure on ehealth could improve mental health treatment and service provision in the western Murray Darling Basin of New South Wales, Australia. Findings Through the use of targeted ehealth strategies, it is possible to increase both the accessibility of information and the quality of service provision. In small communities, the challenges of distance, access to healthcare and the ease of isolating oneself are best overcome through a combination of technology and communal social responsibility. Technology supplements but cannot completely replace face-to-face interaction in the mental health recovery process. Originality/value The recovery model provides a conceptual framework for health informatics in rural and remote regions that is socially responsible. Service providers can affect better recovery for clients through infrastructure that enables timely and responsive remote access whilst driving between appointments. This could include interactive referral services, telehealth access to specialist clinicians, GPS for locating clients in remote areas and mobile coverage for counselling sessions in “real time”. Thus, the technology not only provides better connections but also adds to the responsiveness (and success) of any treatment available.
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Stanton, Robert, and Simon Rosenbaum. "Temporal trends in exercise physiology services in Australia—Implications for rural and remote service provision." Australian Journal of Rural Health 27, no. 6 (November 11, 2019): 514–19. http://dx.doi.org/10.1111/ajr.12563.
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Almeida, Magda Moura, Mayara Floss, Leonardo Vieira Targa, John Wynn-Jones, and Alan Bruce Chater. "It is time for rural training in family medicine in Brazil!" Revista Brasileira de Medicina de Família e Comunidade 13, no. 40 (April 30, 2018): 1–4. http://dx.doi.org/10.5712/rbmfc13(40)1696.
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The gap between health needs and the training of human resources for health is much more evident in rural areas. In Brazil, a country of continental dimensions, these differences become more challenging. The diversity of geographical and administrative barriers to access makes the health indicators of rural and remote populations worse than those of the urban population. Family Medicine could address the social determinants of health through the provision of human services and play an important role in low-income rural residents’ health status. This essay is an urgent call for the debate on models for projecting heath workforce supply and requirements for rural areas in Brazil.
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Wilkinson, David, Heather McElroy, Justin Beilby, Kathy Mott, Kay Price, Sue Morey, and John Best. "Variation in levels of uptake of Enhanced Primary Care item numbers between rural and urban settings, November 1999 to October 2001." Australian Health Review 25, no. 6 (2002): 123. http://dx.doi.org/10.1071/ah020123.
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We aimed to report on variation in levels of uptake of enhanced primary care item numbers between rural and urban Divisions of General Practice between November 1999 and October 2001.Most providers of EPC services and most services (close to 70%)are located in capital cities and other metropolitan centres. The average number of health assessments done per provider was slightly lower (8-14) in remote than urban and rural (20-30) areas. A similar pattern was observed for care plans, but rates of case conferences were similar in rural and urban areas. However, adjusted for population aged 75 years and over, in all jurisdictions except South Australia, between 30% and 144% more health assessments were done per full time equivalent general practitioner (FTE GP) in rural divisions. For rural and urban Divisions of General Practice, there is a wide range in the rate of services provided, between and within Divisions. However, overall, more services are provided per FTE GP in rural Divisions.
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Kwedza, Ru K., Nicholas Zwar, Julie K. Johnson, and Sarah Larkins. "Identifying leadership for clinical governance in rural and remote primary health care services." Australian Journal of Rural Health 28, no. 4 (July 26, 2020): 414–16. http://dx.doi.org/10.1111/ajr.12653.
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Shah, Tayyab Ikram, Stephan Milosavljevic, and Brenna Bath. "Measuring geographical accessibility to rural and remote health care services: Challenges and considerations." Spatial and Spatio-temporal Epidemiology 21 (June 2017): 87–96. http://dx.doi.org/10.1016/j.sste.2017.04.002.
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Cox, Ruth, and Delena Amsters. "GOAL ATTAINMENT SCALING: AN EFFECTIVE OUTCOME MEASURE FOR RURAL AND REMOTE HEALTH SERVICES." Australian Journal of Rural Health 10, no. 5 (June 28, 2008): 256–61. http://dx.doi.org/10.1111/j.1440-1584.2002.tb00041.x.
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Wakerman, John, and John S. Humphreys. "Sustainable primary health care services in rural and remote areas: Innovation and evidence." Australian Journal of Rural Health 19, no. 3 (May 23, 2011): 118–24. http://dx.doi.org/10.1111/j.1440-1584.2010.01180.x.
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Cox, Ruth, and Delena Amsters. "Goal Attainment Scaling: An Effective Outcome Measure for Rural And Remote Health Services." Australian Journal of Rural Health 10, no. 5 (October 2002): 256–61. http://dx.doi.org/10.1046/j.1440-1584.2002.00426.x.
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Morelli, Niccolò. "Pandemic and Family Caregiving in Rural Areas. Reflections After a Participatory Digital Health Intervention in Valle Camonica." SALUTE E SOCIETÀ, no. 1 (February 2022): 113–27. http://dx.doi.org/10.3280/ses2022-001008.
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The current pandemic has resulted in the withdrawal of all social and health services not aimed at combatting COVID-19. This has led to a weakening of care services for family caregivers, especially in remote areas. Moreover, the pandemic has revealed all the frailties of a socio-health system that rarely involves caregivers in the co-design of services. However, in recent years, there has been a debate about the importance of promoting participatory interventions to support carers. Digital health (DH) intervention has been suggested as a successful tool to as-sist remote carers and engage them. This article reflects on the outcomes of a participatory DH intervention in Valle Camonica for family caregivers. The results indicated how DH could be a valid solution to train caregivers safely and effectively, but also how these interventions could not be considered as a panacea for all the weaknesses of health and social services. Mutual psychological support and community belonging among caregivers are not optimal in a remote connection dimension. This article contributes to the literature on the engagement of caregivers in the co-design of care interventions, with particular attention to DH, by pointing out by pointing out certain aspects that need to be considered in the implementation amongst a fragile population in a rural setting.
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Gwynne, Kylie, and Michelle Lincoln. "Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review." Australian Health Review 41, no. 2 (2017): 234. http://dx.doi.org/10.1071/ah15241.
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Objective The aim of the present study was to identify evidence-based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods A systematic search strategy was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results There were four key findings of the study: (1) the experience of Aboriginal people in the health workforce affects their engagement with education, training and employment; (2) particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; (3) attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and (4) student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers. What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce. What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides evidence-based strategies in four key areas. What are the implications for practitioners? The findings of the present study are relevant for policy makers, funders and program managers in rural and remote Aboriginal health.
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Memon, Zahid, Shehla Zaidi, and Atif Riaz. "Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan." Global Journal of Health Science 8, no. 7 (November 3, 2015): 47. http://dx.doi.org/10.5539/gjhs.v8n7p47.
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<p>Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers.</p>
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Zhao, Yuejen, and Rosalyn Malyon. "Cost drivers of remote clinics: remoteness and population size." Australian Health Review 34, no. 1 (2010): 101. http://dx.doi.org/10.1071/ah09685.
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This report examines the impact of remoteness and population size on the costs of providing primary health care services in remote Northern Territory Indigenous communities. For remote health clinics servicing a population of similar size, total expenditure increased as remoteness increased. Total expenditure in remote clinics increased with population size, but average per capita expenditure was highest in clinics servicing populations of less than 200 people and lowest for populations of between 600 and 999. Staffing costs comprised over 70% of expenses. The largest non-staffing cost was property management. The higher costs of clinics that are in more remote locations or servicing smaller populations need to be recognised in funding distribution methodologies. What is known about the topic?People in rural and remote locations tend to have poorer health status and poorer access to primary care services than those in urban areas. There has, however, been a lack of information on the relative cost of providing primary care services in remote areas and the nature of those costs, particularly in remote Indigenous communities. What does this paper add?This study analyses the costs of primary care services in Northern Territory remote Indigenous communities and their associations with two key cost drivers: remoteness and population size. What are the implications for practitioners?This paper provides information on the importance of including remoteness and population size in resource allocation formulas for primary care services in remote areas.
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O'Sullivan, Belinda G., Matthew R. McGrail, and Johannes U. Stoelwinder. "Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study." Australian Health Review 41, no. 3 (2017): 344. http://dx.doi.org/10.1071/ah16032.
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Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n = 110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n = 154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are more likely to provide remote outreach services. The RHOF, as a formally structured comprehensive subsidy, further targets the provision of priority services into such locations on a regular, ongoing basis.
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Meehan-Andrews, Terri, Judith Jones, and John Humphreys. "How do we Canvass Rural Consumer Viewpoints for Health Care Planning and Quality Assurance? Methodological Considerations for Data Collection." Australian Journal of Primary Health 12, no. 3 (2006): 72. http://dx.doi.org/10.1071/py06048.
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Consumer input is vitally important when planning health care services and monitoring health system performance. Australia's rural residents suffer poorer health status and health outcomes than do metropolitan residents; this, along with medical and health workforce shortages, makes this planning and monitoring especially relevant. In rural and remote regions people are geographically dispersed across diverse communities, often making it difficult to access and recruit consumers. This paper provides a framework to address the major issues associated with how best to canvass representative rural consumer views relating to health care services and quality assurance. The review provides a critical appraisal of the advantages and disadvantages of the main methodologies employed in rural health studies. Many of the problems associated with gaining representative rural consumer perspectives in relation to health can be overcome by planning the research process, adopting the appropriate survey tool and engaging potential participants.
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Kopel, Heidi, Kenneth Nunn, and David Dossetor. "Evaluating satisfaction with a child and adolescent psychological telemedicine outreach service." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 35–40. http://dx.doi.org/10.1258/1357633011937074.
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A child and adolescent telepsychiatry service in rural New South Wales was evaluated. Part of the evaluation was to assess whether rural mental health workers and patients were satisfied with the videoconferencing services provided by child psychiatrists from the Children's Hospital at Westmead. During a 12-month study, information was collected using questionnaires on a total of 136 new patients who had been interviewed via videoconferencing. Satisfaction questionnaires were completed by 100 rural mental health workers, and 82 patients and their families/carers. Questionnaires about satisfaction with the technology were completed by 136 child psychiatrists, 101 rural mental health workers and 79 patients. Patients and their families/carers, as well as rural clinicians, expressed high overall satisfaction with the telepsychiatry service. The evaluation suggested that videoconferencing is a good method of providing child and adolescent psychiatry services to remote and rural communities.
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Russell, Deborah Jane, John Wakerman, and John Stirling Humphreys. "What is a reasonable length of employment for health workers in Australian rural and remote primary healthcare services?" Australian Health Review 37, no. 2 (2013): 256. http://dx.doi.org/10.1071/ah12184.
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Background. Optimising retention of rural and remote primary healthcare (PHC) workers requires workforce planners to understand what constitutes a reasonable length of employment and how this varies. Currently, knowledge of retention patterns is limited and there is an absence of PHC workforce benchmarks that take account of differences in geographic context and profession. Methods. Three broad strategies were employed for proposing benchmarks for reasonable length of stay. They comprised: a comprehensive literature review of PHC workforce-retention indicators and benchmarks; secondary analysis of existing Australian PHC workforce datasets; and a postal survey of 108 rural and remote PHC services, identifying perceived and actual workforce-retention patterns of selected professional groups. Results. The literature review and secondary data analysis revealed little that was useful for establishing retention benchmarks. Analysis of primary data revealed differences in retention by geographic location and profession that took time to emerge and were not sustained indefinitely. Provisional benchmarks for reasonable length of employment were developed for health professional groups in both rural and remote settings. Conclusions. Workforce-retention benchmarks that differ according to geographic location and profession can be empirically derived, facilitating opportunities for managers to improve retention performance and reduce the high costs of staff replacement. What is known about the topic? Health services located in small rural and remote locations are likely to continue to experience workforce shortages and high costs of recruitment. Health workforce retention is therefore crucial. However, effective rural health workforce planning and use of strategies to maximise retention of existing health workers is hindered by inadequate knowledge about baseline employment-retention patterns. What does this paper add? Differences in health worker retention patterns by geographic location and profession are most evident after the first 6 months through until the end of the second year of employment. Health worker-retention benchmarks that differ according to geographic location and profession are proposed. What are the implications for practitioners? Benchmarking workforce retention in comparable health services can enable identification of best practice and the underpinning retention strategies. Workforce planners can use this, together with knowledge of baseline retention patterns and the high cost of staff replacement, to guide the design, timing and implementation of cost-neutral retention strategies.
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Cord-Udy, Nigel. "The Medical Specialist Outreach Assistance Programme in South Australia." Australasian Psychiatry 11, no. 2 (June 2003): 189–94. http://dx.doi.org/10.1046/j.1039-8562.2003.00532.x.
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Objective: The present paper aims to provide an overview of the Medical Specialist Outreach Assistance Programme (MSOAP) and its implementation in South Australia with particular reference to the expansion of visiting psychiatric services to rural and remote areas. Included is a discussion of a number of the practical issues and challenges experienced by the author in the development of a visiting psychiatric service to the remote community of Coober Pedy in northern South Australia. Conclusions: There has been much success to date with the expansion of visiting psychiatric services to rural and remote areas within South Australia under MSOAP. MSOAP appears to have considerable merit, particularly for psychiatrists working in private practice. There are several practical issues to be considered in taking on this type of work. The professional rewards are substantial.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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O’Donnell, Elen, Bridget Honan, Simon Quilty, and Rebecca Schultz. "The Effect of Heat Events on Prehospital and Retrieval Service Utilization in Rural and Remote Areas: A Scoping Review." Prehospital and Disaster Medicine 36, no. 6 (November 2, 2021): 782–87. http://dx.doi.org/10.1017/s1049023x21001163.
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AbstractIntroduction:It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context.Inclusion Criteria:Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area.Methods:A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote. Data relevant to the impact of heat on retrieval service activity were extracted, as well as definitions of extreme heat.Results:Two papers were identified, both from Australia. Both found that heat events increased the number of road ambulance call-outs. Both studies used the Excess Heat Factor (EHF) to define heatwave periods of interest.Conclusions:This review found almost no primary literature on demand for prehospital retrieval services in rural and remote areas, and no data specifically related to aeromedical transport. The research did recognize the disproportionate impact of heat-related increase in service demand on Australian rural and regional health services. With the effects of climate change already being felt, there is an urgent need for more research and action in this area.