Journal articles: 'Rural health – Western Australia'

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Lower, T., G. Durham, D. Bow, and A. Larson. "Implementation of the Australian core public health functions in rural Western Australia." Australian and New Zealand Journal of Public Health 28, no. 5 (October 2004): 418–25. http://dx.doi.org/10.1111/j.1467-842x.2004.tb00023.x.

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Playford, Denese E., and Edwina Cheong. "Rural Undergraduate Support and Coordination, Rural Clinical School, and Rural Australian Medical Undergraduate Scholarship: rural undergraduate initiatives and subsequent rural medical workforce." Australian Health Review 36, no. 3 (2012): 301. http://dx.doi.org/10.1071/ah11072.

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Background. This study examined postgraduate work after an undergraduate clinical year spent in the Rural Clinical School of Western Australia (RCSWA), compared with 6 weeks Rural Undergraduate Support and Coordination (RUSC)-funded rural experience in a 6-year undergraduate medical course. Rural background, sex and Rural Australian Medical Undergraduate Scholarship (RAMUS)-holding were taken into account. Methods. University of Western Australia undergraduate data were linked by hand with postgraduate placements to provide a comprehensive dataset on the rural exposure history of junior medical practitioners working in Western Australia between 2004 and 2007. Results. Participation in the RCSWA program was associated with significantly more postgraduate year one rural work than RUSC placement alone (OR = 1.5, CI 0.97–2.38). The RCSWA workforce effect increased at postgraduate year two (OR = 3.0, CI 1.6484 to 5.5935 relative to RUSC). Rural-origin practitioners who chose the RCSWA program were more likely than other rural-origin practitioners to take rural rotations in both postgraduate years. RAMUS holders’ choice in relation to the RCSWA program predicted later rural work. There were no effects of sex. Conclusions. Rural initiatives, in particular the Rural Clinical School program, are associated with postgraduate rural choices. The real impact of these data rely on the translation of early postgraduate choices into long-term work commitments. What is known about the topic? Specific training of rural graduates is strongly related to subsequent rural workforce. In addition, rural educational placements affect medical students’ intentions to practise rurally. Retrospective data from rural relative to urban general practitioners link rural background, rural undergraduate experience and rural postgraduate experience with rural work. What does this paper add? Much of the Australian prospective outcomes research has looked at workforce intentions of graduates, or the workforce outcomes of small graduate cohorts of Rural Clinical Schools. This paper followed nearly 500 graduates by name through to their PGY1 and PGY2 workforce decisions. As this cohort comprised 80% of three completely graduated MBBS years, these data validly represent the outcome of a medical school which is comparable to all Australian medical schools in its RUSC, Rural Clinical School and RAMUS recipients. The paper provides the first peer-reviewed outcomes data for the RAMUS scholarship program. What are the implications for practitioners? Rural supervision of medical students is an effective way to recruit new workforce. The longer students are supervised in rural settings, the better. But undergraduate programs need to be linked with postgraduate initiatives that take graduates of medical student initiatives into vocational programs able to deliver a trained rural workforce.

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Aoun, Samar, and Lyn Johnson. "CAPACITY BUILDING IN RURAL MENTAL HEALTH IN WESTERN AUSTRALIA." Australian Journal of Rural Health 10, no. 1 (June 28, 2008): 39–44. http://dx.doi.org/10.1111/j.1440-1584.2002.tb00007.x.

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Kruger, E., K. Dyson, and M. Tennant. "Pre-school child oral health in rural Western Australia." Australian Dental Journal 50, no. 4 (December 2005): 258–62. http://dx.doi.org/10.1111/j.1834-7819.2005.tb00370.x.

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Aoun, Samar, and Lyn Johnson. "CAPACITY BUILDING IN RURAL MENTAL HEALTH IN WESTERN AUSTRALIA." Australian Journal of Rural Health 10, no. 1 (February 2002): 39–44. http://dx.doi.org/10.1046/j.1440-1584.2002.00407.x.

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Costello, D., M. Johns, B. Jackson, S. Nannup, and S. O'Brien. "Preventing suicide in rural and remote Western Australia." Injury Prevention 16, Supplement 1 (September 1, 2010): A201. http://dx.doi.org/10.1136/ip.2010.029215.717.

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van Spijker, Bregje A., Jose A. Salinas-Perez, John Mendoza, Tanya Bell, Nasser Bagheri, Mary Anne Furst, Julia Reynolds, et al. "Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas." Australian & New Zealand Journal of Psychiatry 53, no. 10 (June 28, 2019): 1000–1012. http://dx.doi.org/10.1177/0004867419857809.

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Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.

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Costello, D., and M. O'Brien. "Grass roots suicide prevention in rural Western Australia (WA)." Injury Prevention 18, Suppl 1 (October 2012): A161.2—A161. http://dx.doi.org/10.1136/injuryprev-2012-040590m.24.

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Kruger, Estie, and Mark Tennant. "Oral health workforce in rural and remote Western Australia: Practice perceptions." Australian Journal of Rural Health 13, no. 5 (October 2005): 321–26. http://dx.doi.org/10.1111/j.1440-1584.2005.00724.x.

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Ramsden, Robyn, Richard Colbran, Tricia Linehan, Michael Edwards, Hilal Varinli, Carolyn Ripper, Angela Kerr, et al. "Partnering to address rural health workforce challenges in Western NSW." Journal of Integrated Care 28, no. 2 (November 4, 2019): 145–60. http://dx.doi.org/10.1108/jica-06-2019-0026.

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Purpose While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural and remote communities. The purpose of this paper is to explore a partnership approach to understanding and addressing complex primary health workforce issues in the western region of New South Wales (NSW), Australia. Design/methodology/approach The authors describe how a collaboration of five organisations worked together to engage a broader group of stakeholders and secure commitment and resources for a regional approach to address workforce challenges in Western NSW. A literature review and formal interviews with stakeholders gathered knowledge, identified issues and informed the overarching approach, including the development of the Western NSW Partnership Model and Primary Health Workforce Planning Framework. A stakeholder forum tested the proposed approach and gained endorsement for a collaborative priority action plan. Findings The Western NSW Partnership Model successfully engaged regional stakeholders and guided the development of a collaborative approach to building a sustainable primary health workforce for the future. Originality/value Given the scarcity of literature about effective partnerships approaches to address rural health workforce challenges, this paper contributes to an understanding of how to build sustainable partnerships to positively impact on the rural health workforce. This approach is replicable and potentially valuable elsewhere in NSW, other parts of Australia and internationally.

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Haythornthwaite, Sarah. "Videoconferencing training for those working with at-risk young people in rural areas of Western Australia." Journal of Telemedicine and Telecare 8, no. 3_suppl (December 2002): 29–33. http://dx.doi.org/10.1258/13576330260440772.

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summary Rural Links is a videoconference training initiative developed for those who work with at-risk young people in remote and rural regions of Western Australia. The training programme was run twice (in parallel) for two groups of participants: 17 workers from the Great Southern and South West regions of Western Australia and 15 workers from the Wheatbelt, Pilbara and Kimberley regions of Western Australia. The programme consisted of seven 2 h sessions presented over 12 weeks. Objectives of the training programme centred on increasing participants’ knowledge and confidence in relation to the training topics. The initiative also aimed to enhance consultation between rural youth networks and a metropolitan-based youth mental health service (YouthLink). Analyses indicated that there were improvements in workers’ knowledge and confidence in relation to training topics following participation in the programme. Comparisons of the improvements made by these rural participants, who accessed training via videoconferencing, and metropolitan participants, who accessed training face to face, revealed few significant differences. Rural participants reported high levels of satisfaction, decreased feelings of professional isolation and an increased likelihood of accessing YouthLink for consultative support as a result of completing the Rural Links training programme.

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Ng, Jonathon Q., Sonja E. Hall, C. D’Arcy J. Holman, and James B. Semmens. "INEQUALITIES IN RURAL HEALTH CARE: DIFFERENCES IN SURGICAL INTERVENTION BETWEEN METROPOLITAN AND RURAL WESTERN AUSTRALIA." ANZ Journal of Surgery 75, no. 5 (May 2005): 265–69. http://dx.doi.org/10.1111/j.1445-2197.2005.03375.x.

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Gracey, Michael, Peta Williams, and Shane Houston. "Environmental health conditions in remote and rural Aboriginal communities in Western Australia." Australian and New Zealand Journal of Public Health 21, no. 5 (August 1997): 511–18. http://dx.doi.org/10.1111/j.1467-842x.1997.tb01744.x.

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Speldewinde, Peter C., Angus Cook, Peter Davies, and Philip Weinstein. "A relationship between environmental degradation and mental health in rural Western Australia." Health & Place 15, no. 3 (September 2009): 880–87. http://dx.doi.org/10.1016/j.healthplace.2009.02.011.

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Lower, Tony, Rick Ladyshewsky, Joan Loud, and Sally Moore. "Enhancing Supervision Skills for Rural Placements through Video-conferencing in Western Australia." Australian Journal of Primary Health 8, no. 3 (2002): 94. http://dx.doi.org/10.1071/py02049.

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This paper examines the use of video-conferencing technology as a medium to deliver preceptor/supervisor training in a multidisciplinary context in rural Western Australia. A video-conference involvIng three rural sites and a transmission site in Perth was conducted. The one-day training program covered the generic issues involved with student supervision. Based on feedback from participants, results illustrate a wide acceptance of the generic supervision content and a moderate acceptance of the video-conferencing technology as a delivery medium. Although further refinement of the manner in which video-conferences are delivered is required, this study supports the utility of video-conferencing as a means to deliver supervision training in a multidisciplinary manner in rural areas.

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Jose, Diana, Marisa Gilles, and Sarah-Jane Kelley. "Audit of opportunistic immunisation of paediatric inpatients in rural Western Australia." Australian and New Zealand Journal of Public Health 40, no. 1 (October 11, 2015): 97–98. http://dx.doi.org/10.1111/1753-6405.12465.

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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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Shaw, Peter, Marg Lundy, and Ann Larson. "Rural health professionals' use of a clinical information web site in Western Australia." Australian Journal of Rural Health 14, no. 1 (February 2006): 36–38. http://dx.doi.org/10.1111/j.1440-1584.2006.00754.x.

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Balaratnasingam, Sivasankaran. "The Wild West: Rural and Remote Psychiatry Training in North Western Australia." Australasian Psychiatry 16, no. 5 (January 1, 2008): 322–25. http://dx.doi.org/10.1080/10398560801995269.

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Objective: The author reflects on his rural psychiatric training in North Western Australia, having gained over 2 years’ experience as a basic and advanced trainee in this setting. The unique rewards and benefits of rural training are discussed along with the challenges of working in an isolated setting with resource constraints. Conclusions: Rural and remote training remains a stimulating and professionally satisfying experience that is under-utilized by many trainees. In spite of most training requirements being able to be met in this setting, trainees are reluctant to undertake this valuable and enjoyable training experience. Trainees are encouraged to consider this opportunity to be upskilled and getting involved on a more personal level with patients, families and general practitioners, thereby enhancing their clinical skills and shaping their professional identity as future psychiatrists.

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Fletcher, Sophie, Craig Sinclair, Joel Rhee, Desiree Goh, and Kirsten Auret. "Rural health professionals‘ experiences in implementing advance care planning: a focus group study." Australian Journal of Primary Health 22, no. 5 (2016): 423. http://dx.doi.org/10.1071/py15004.

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Advance care planning (ACP) is described as an ongoing discussion between a patient, their family and healthcare professionals (HCPs) to understand a patient’s wishes for future health care. Legislation supporting ACP in Western Australia is relatively new and HCPs are still learning about the process and implementation. This study aimed to provide a rich description of rural health professionals’ perceptions and experiences with ACP within the context of their professional role and to identify systemic issues and training needs. Ten focus groups were conducted throughout 2014 with a total of 55 rural participants including general practitioners (n=15), general practice registrars (n=6), practice nurses (n=18), community nurses (n=4) and hospital nurses (n=12) in the south-western regions of Western Australia. Thematic analysis has identified the following themes regarding ACP: benefits to patients and families; professional roles in ACP; barriers and enablers; and systems for communicating ACP. HCPs have self-determined their roles in the ACP process, which currently leaves some components of the process unaccounted for, suggesting that collaboration between HCPs working together in a rural health setting and a standardised system for distributing these documents may assist with the implementation of ACP.

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Musk, Arthur W., Nola J. Olsen, Alison Reid, Tim Threlfall, and Nicholas H. de Klerk. "Asbestos-related disease from recycled hessian superphosphate bags in rural Western Australia." Australian and New Zealand Journal of Public Health 30, no. 4 (August 2006): 312–13. http://dx.doi.org/10.1111/j.1467-842x.2006.tb00840.x.

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Smith, Kirrilee, and Marc Tennant. "Demographic analysis of currently registered dentists in Western Australia: Rural urban divide." Australian Journal of Rural Health 14, no. 3 (June 2006): 126–28. http://dx.doi.org/10.1111/j.1440-1584.2006.00782.x.

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Meuleners, Lynn B., Andy H. Lee, Jianhong Xia, Michelle Fraser, and Delia Hendrie. "Interpersonal violence presentations to general practitioners in Western Australia: implications for rural and community health." Australian Health Review 35, no. 1 (2011): 70. http://dx.doi.org/10.1071/ah10913.

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Objective. To estimate the incidence of interpersonal violence presentations to general practitioners (GPs). Methods. A postal survey of all GPs in Western Australia (WA) was conducted in 2009 using a structured questionnaire. Results. Among the n = 476 respondents (response rate 28%), 379 GPs treated 9572 patients for a violent incident during the past year. The rate of violent presentations in rural WA was double that of metropolitan areas (incident rate ratio (IRR) 1.9, 95% CI 1.8–2.0), whereas the rate of violent episodes in remote GP practices was 7-fold higher (IRR 7.2, 95% CI 6.8–7.6). Halls Creek in remote northern WA was found to be a ‘hot spot’ with a high cluster of violence cases, whereas metropolitan suburbs surrounding Perth had relatively low concentrations of violence presentations. Conclusions. Further understanding of the size and nature of the problem is required in view of the low response rate. High-risk groups, such as women and those living in rural and remote areas, should be targeted for special attention. What is known about the topic? Previous studies of interpersonal violence have been based on victim surveys or crime databases, which are subjected to both under- and over-reporting. Hospital admission and mortality statistics represent severe injuries resulting from violence episodes. However, victims who sought treatment from GPs are not routinely recorded. What does this paper add? Rural and remote GP practices reported a higher incident of violent presentations than their metropolitan counterparts. The finding provides a basis to further investigate the level of GP services for treating interpersonal violence injuries. What are the implications for practitioners? Sentinel surveillance of GPs is recommended. High-risk groups such as women and those living in rural and remote areas should be targeted for attention.

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Aoun, Samar. "Deliberate self-harm in rural Western Australia: Results of an intervention study." Australian and New Zealand Journal of Mental Health Nursing 8, no. 2 (June 1999): 65–73. http://dx.doi.org/10.1046/j.1440-0979.1999.00133.x.

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Slavova-Azmanova, Neli S., Jade C. Newton, Claire E. Johnson, Harry Hohnen, Angela Ives, Sandy McKiernan, Violet Platt, Max Bulsara, and Christobel Saunders. "A cross-sectional analysis of out-of-pocket expenses for people living with a cancer in rural and outer metropolitan Western Australia." Australian Health Review 45, no. 2 (2021): 148. http://dx.doi.org/10.1071/ah19265.

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ObjectiveTo determine the extent of medical and non-medical out-of-pocket expenses (OOPE) among regional/rural and outer metropolitan Western Australian patients diagnosed with cancer, and the factors associated with higher costs. MethodsCross-sectional data were collected from adult patients living in four regional/rural areas and two outer metropolitan regions in Western Australia who had been diagnosed with breast, prostate, colorectal or lung cancer. Consenting participants were mailed demographic and financial questionnaires, and requested to report all OOPE related to their cancer treatment. ResultsThe median total OOPE reported by 308 regional/rural participants and 119 outer metropolitan participants were A$1518 (interquartile range (IQR): A$581–A$3769) and A$2855 (IQR: A$958–A$7142) respectively. Participants most likely to experience higher total OOPE were younger than 65 years of age, male, resided in the outer metropolitan area, worked prior to diagnosis, had private health insurance, were in a relationship, and underwent surgery. Multivariate analysis of regional/rural participants revealed that receiving care at a rural cancer centre was associated with significantly lower non-medical OOPE (estimated mean A$805, 95% confidence interval (CI): A$735–A$875, P=0.038; compared with other rural participants (A$1347, 95% CI: A$743–A$1951, P<0.001)). ConclusionThe cancer patients who participated in this study experienced variation in OOPE, with outer metropolitan participants reporting higher OOPE compared with their regional/rural counterparts. There is a need for cost transparency and access to care close to home, so that patients can make informed choices about where to receive their care. What is known about the topic?In recent years, OOPE for health care in general and cancer in particular have been widely debated by consumers and not-for-profit organisations; the topic has attracted much political attention because it affects both equity and access to care and has wider financial implications for the community. Research studies and reports from both consumer organisations and a Ministerial Advisory Committee found that cancer patients can face exorbitant out-of-pocket costs, and that individuals with private health insurance and those with prostate and breast cancer reported higher costs. In Western Australia, a cancer centre providing comprehensive cancer care was established in the second most populous region to ameliorate the high costs for travel and accommodation that regional cancer patients are known to experience. What does this paper add?This study is unique because it collected detailed cost information from patients and reports on the OOPE of regional/rural and outer metropolitan Western Australian patients receiving care for one of the four most common cancers; it therefore offers novel insight into the experiences of these groups. This study demonstrates that outer metropolitan cancer patients are experiencing much higher OOPE compared with regional/rural cancer patients. Additionally, regional/rural study participants who accessed a Regional Cancer Centre experienced significantly lower non-medical OOPE, compared with regional/rural study participants receiving care elsewhere. What are the implications for practitioners?First, there is a need for improved communication of OOPE to minimise costs to the patient, for example, by facilitating access to local cancer care. Health service providers and insurance companies can improve cost transparency for cancer patients by making this information more readily available, allowing patients to make informed financial choices about where to seek care. Second, the needs of working patients deserve specific attention. These patients face significant work uncertainty and additional distress following a cancer diagnosis.

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Tennant, Chris, and Derrick Silove. "The development of a mental health service in East Timor: an Australian mental health relief project." International Psychiatry 2, no. 8 (April 2005): 17–19. http://dx.doi.org/10.1192/s1749367600007232.

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East Timor (the Democratic Republic of Timor-Leste) occupies the eastern half of the island of Timor, which lies between North Western Australia and the Indonesian archipelago. East Timor has a population of around 860 000. It is predominantly rural and there are few large towns. The country has a largely subsistence agricultural economy; coffee is the principal cash crop. The population is extremely poor, and transport and communications are primitive.

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Tearne, Elizabeth, Kylee Cox, and Roslyn Giglia. "Patterns of Alcohol Intake of Pregnant and Lactating Women in Rural Western Australia." Maternal and Child Health Journal 21, no. 11 (September 7, 2017): 2068–77. http://dx.doi.org/10.1007/s10995-017-2318-8.

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de Silva, Andrea M., Jacqueline Martin-Kerry, Alexandra Geale, and Deborah Cole. "Flying blind: trying to find solutions to Indigenous oral health." Australian Health Review 40, no. 5 (2016): 570. http://dx.doi.org/10.1071/ah15157.

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Objective The aim of the present study was to identify all published evidence about oral health in Indigenous children in Australia and to determine trends in Indigenous oral health over time. Methods PubMed was used to search for published peer-reviewed articles that reported caries (decay) prevalence rates and/or caries experience (based on caries indices) in Indigenous children. Studies included in the analysis needed to report clinical oral health data (not self-reported dental experiences), and articles were excluded if they reported caries in only a select, specific or targeted sample (e.g. only children undergoing hospital admissions for dental conditions). Results The review identified 32 studies that met the inclusion criteria. These studies reported data from the Northern Territory (n = 14), Western Australia (n = 7), South Australia (n = 7), Queensland (n = 7), New South Wales (n = 1), Australian Capital Territory (n = 1) and Tasmania (n = 1). Of the studies, 47% were in rural locations, 9% were in urban locations and 44% were in both rural and urban locations. Data are limited and predominantly for Indigenous children living in rural locations, and there are no published studies on caries in Indigenous children living in Victoria. Conclusions The present study documents the published prevalence and severity of caries in Indigenous children living in Australia and highlights that limited oral health data are available for this priority population. Although risk factors for oral disease are well known, most of the studies did not analyse the link between these factors and oral disease present. There is also inconsistency in how caries is reported in terms of age and caries criteria used. We cannot rely on the available data to inform the development of policies and programs to address the oral health differences in Indigenous populations living contemporary lives in metropolitan areas. What is known about the topic? Many studies report that Indigenous people have poorer general health in Australia compared with non-Indigenous people. What does this paper add? This paper documents the available published prevalence and experience of caries for Indigenous children in Australia. It demonstrates significant limitations in the data, including no Victorian data, inconsistency with reporting methods and most data being for Indigenous children who are living in rural locations. What are the implications for practitioners? It is important for practitioners to have access to oral health data for Indigenous children in Australia. However, the present study highlights significant knowledge gaps for this population group and identifies ways to collect data in future studies to enable more meaningful comparisons and policy development.

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Buckley, Dermot, and Tony Lower. "Factors influencing the utilisation of health services by rural men." Australian Health Review 25, no. 2 (2002): 11. http://dx.doi.org/10.1071/ah020011.

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This research identified the barriers and enablers that influence the utilisation of health services by rural men in the Midwest region of Western Australia. The methodology was based on participatory action research, including qualitative assessments to determine the issues for a larger quantitative study. Four variables were identified as predictors for the use of health services: those who attended for preventive reasons; those not affected by seasonal work;men who thought a medical telephone line was not important; and those who did not consider privacy an important issue. Modification of health service delivery to men could potentially enhance appropriate utilisation of health services in rural areas.

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Cuesta-Briand, Beatriz, Mathew Coleman, Rebekah Ledingham, Sarah Moore, Helen Wright, David Oldham, and Denese Playford. "Extending a Conceptual Framework for Junior Doctors’ Career Decision Making and Rural Careers: Explorers versus Planners and Finding the ‘Right Fit’." International Journal of Environmental Research and Public Health 17, no. 4 (February 20, 2020): 1352. http://dx.doi.org/10.3390/ijerph17041352.

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This study uses data from a Rural Clinical School of Western Australia (RCSWA) and WA Country Health (WACHS) study on rural work intentions among junior doctors to explore their internal decision-making processes and gain a better understanding of how junior doctors make decisions along their career pathway. This was a qualitative study involving junior doctor participants in postgraduate years (PGY) 1 to 5 undergoing training in Western Australia (WA). Data was collected through semi-structured telephone interviews. Two main themes were identified: career decision-making as an on-going process; and early career doctors’ internal decision-making process, which fell broadly into two groups (‘explorers’ and ‘planners’). Both groups of junior doctors require ongoing personalised career advice, training pathways, and career development opportunities that best “fit” their internal decision-making processes for the purposes of enhancing rural workforce outcomes.

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Lim, Adrian C., Adrian C. See, and Stephen P. Shumack. "Progress in Australian teledermatology." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 55–58. http://dx.doi.org/10.1258/1357633011937146.

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Because of their remoteness, the majority of rural towns in Australia are disadvantaged in terms of access to dermatological services. Telemedicine offers one solution. Since the mid-1990s, Australian dermatologists have experimented with tele-medicine as an adjunct to clinical practice. The technical viability of teledermatology was first demonstrated in 1997. In 1999, the accuracy and reliability of teledermatology were demonstrated in a real-life urban setting. In 2001, Broken Hill (in western New South Wales), a location remote from dermatology services, served as a trial site for the institution of tele-dermatology as the primary method of accessing dermatological services. High patient and general practitioner acceptability and positive medical outcomes were demonstrated, but the study also revealed unexpected barriers and pitfalls in the effective operation of rural teledermatology.

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Scott, Jessica, Ann Larson, Felicity Jefferies, and Bert Veenendaal. "Small-area estimates of general practice workforce shortage in rural and remote Western Australia." Australian Journal of Rural Health 14, no. 5 (October 2006): 209–13. http://dx.doi.org/10.1111/j.1440-1584.2006.00811.x.

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Lin, Ivan, Belinda Goodale, Karen Villanueva, and Suzanne Spitz. "Supporting an emerging workforce: Characteristics of rural and remote therapy assistants in Western Australia." Australian Journal of Rural Health 15, no. 5 (October 2007): 334–39. http://dx.doi.org/10.1111/j.1440-1584.2007.00917.x.

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Fung, Thomas, Penelope Abbott, Amit Arora, Ajesh George, Amy Villarosa, and Jennifer Reath. "Oral health care in urban general practice: what are the support and training needs?" Australian Journal of Primary Health 27, no. 4 (2021): 265. http://dx.doi.org/10.1071/py20239.

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Patients with oral health problems often attend GPs instead of dentists, particularly in rural areas. There has been little research exploring challenges in providing oral health care in urban general practice. A cross-sectional survey of GPs in Greater Western Sydney explored their experiences, knowledge, confidence, and their oral health educational needs. Descriptive statistics and content analysis was undertaken. Forty-nine GPs reported experience of a wide range of oral health presentations. Approximately 60% were confident to undertake oral health examinations and determine the cause of acute toothache. Although 87% were confident providing preventative oral health advice, most did not include this in routine health assessments. Only 41% were confident explaining eligibility for public dental services. Barriers to providing oral health care were time constraints, lack of equipment and limited oral health training. Our research highlights oral health support and training needs in urban Australian general practice, as well as the need for systems-wide change to oral health training in outer urban settings to tackle health inequity, similar to those advocated in rural Australia.

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Nazareth, Saroja, Nickolas Kontorinis, Niroshan Muwanwella, Alan Hamilton, Nadine Leembruggen, and Wendy Sc Cheng. "Successful treatment of patients with hepatitis C in rural and remote Western Australia via telehealth." Journal of Telemedicine and Telecare 19, no. 2 (February 2013): 101–6. http://dx.doi.org/10.1258/jtt.2012.120612.

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Rural and remote patients at the Royal Perth Hospital were reviewed and treated for hepatitis C by a hepatologist and nurse practitioner using telehealth (videoconferencing). Over a four-year period, 50 patients were treated with pegylated interferon and ribavirin, and participated in a total of more than 500 telehealth sessions. Sustained virological response rates (SVRs) were compared to those in face-to-face (FTF) clinics to assess treatment outcomes. Treatment through telehealth was found to be non-inferior to FTF clinics. Telehealth patients with genotype 1 infection achieved a higher rate of SVR than those attending FTF clinics (73% versus 54%, respectively), although the difference was not significant. SVR rates for genotype 2 and 3 of 72% were similar in telehealth to FTF rates of 74%. A total of 35 telehealth patients completed a satisfaction questionnaire and most indicated that they were happy with the programme and would participate again in the future. The study confirmed that telehealth is an effective option for the treatment of hepatitis C in rural and remote areas.

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Bowater, Max. "The experience of a rural general practitioner using videoconferencing for telemedicine." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 24–25. http://dx.doi.org/10.1258/1357633011937038.

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A telemedicine link was installed between a mining town in Western Australia and clinical specialists in Perth, about 1800 km away. Standard commercial videoconferencing units connected by ISDN at 128 kbit/s were used. During a two-year period, 90 teleconsultations were carried out. About one-third of the injuries to mining construction workers were eye problems. In more than 75% of teleconsultations a patient transfer to Perth was avoided.

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Shanmugakumar, Sharanyaa, Denese Playford, Tessa Burkitt, Marc Tennant, and Tom Bowles. "Is Western Australia’s rural surgical workforce going to sustain the future? A quantitative and qualitative analysis." Australian Health Review 41, no. 1 (2017): 75. http://dx.doi.org/10.1071/ah15084.

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Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia’s rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the training of general surgeons. What is known about the topic? A paper published in 1998 suggested that Australia’s rural surgeons were soon to reach retirement age. However, there have been no published peer-reviewed papers on Australia’s surgical workforce since then. More recent workforce statistics released from the RACS suggest that the rural workforce is in crisis. What does this paper add? This paper provides up-to-date whole-of-state information for WA, showing where surgical services are being provided and by whom, giving a precise geographical spread of the workforce. It shows the skill set and on-call rosters of these practitioners. What are the implications for practitioners? The present study provides geographical workforce data, which is important to health planners, the general public and surgeons considering where to practice. In particular, these data are relevant to trainees considering their rural training options.

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Forsyth, René, Zhonghua Sun, Christopher Reid, and Rachael Moorin. "Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015." Journal of Clinical Medicine 10, no. 1 (December 25, 2020): 49. http://dx.doi.org/10.3390/jcm10010049.

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Acute coronary syndrome (ACS) is globally recognised as a significant health burden, for which the reduction in total ischemic times by way of the most suitable reperfusion strategy has been the focus of national and international initiatives. In a setting such as Western Australia, characterised by 79% of the population dwelling in the greater capital region, transfers to hospitals capable of percutaneous coronary intervention (PCI) is often a necessary but time-consuming reality for outer-metropolitan and rural patients. Methods: Hospital separations, emergency department admissions and death registration data between 1 January 2007 and 31 December 2015 were linked by the Western Australian Data Linkage Unit, identifying patients with a confirmed first-time diagnosis of ACS, who were either a direct admission or experienced an inter-hospital transfer. Results: Although the presentation rates of ACS remained stable over the nine years evaluated, the rates of first-time admissions for ACS were more than double in the rural residential cohort, including higher rates of ST-segment elevation myocardial infarction, the most time-critical manifestation of ACS. Consequently, rural patients were more likely to undergo an inter-hospital transfer. However, 42% of metropolitan admissions for a first-time ACS also experienced a transfer. Conclusion: While the time burden of inter-hospital transfers for rural patients is a reality in health care systems where it is not feasible to have advanced facilities and workforce skills outside of large population centres, there is a concerning trend of inter-hospital transfers within the metropolitan region highlighting the need for further initiatives to streamline pre-hospital triage to ensure patients with symptoms indicative of ACS present to PCI-equipped hospitals.

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BROOKE, C. J., A. N. CLAIR, A. S. J. MIKOSZA, T. V. RILEY, and D. J. HAMPSON. "Carriage of intestinal spirochaetes by humans: epidemiological data from Western Australia." Epidemiology and Infection 127, no. 2 (October 2001): 369–74. http://dx.doi.org/10.1017/s095026880100588x.

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The purpose of this study was to investigate carriage of intestinal spirochaetes by selected population groups in Western Australia. Stool specimens from 293 rural patients with gastrointestinal disorders, and from 227 healthy migrants from developing countries were cultured. Spirochaete isolates were identified using PCR, and typed by pulsed field gel electrophoresis (PFGE). Brachyspira aalborgi was not isolated. Brachyspira pilosicoli was recovered from 15 rural patients, all Aboriginal. Prevalence was 9·9% in 151 Aboriginals and 0% in 142 non-Aboriginals. Carriage of B. pilosicoli amongst migrants was 10·6% (24/227). Carriage was significantly increased in Aboriginal children aged 2–5 years (P = 0·0027) and in migrant individuals from the Middle East and Africa (P = 0·0034). Carriage was significantly associated with detection of faecal protozoa in both Aboriginals (P = 0·0021) and migrants (P = 0·012). PFGE results indicated that the B. pilosicoli strains were genetically diverse.

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Greville, Heath, Emma Haynes, Robin Kagie, and Sandra C. Thompson. "‘It Shouldn’t Be This Hard’: Exploring the Challenges of Rural Health Research." International Journal of Environmental Research and Public Health 16, no. 23 (November 22, 2019): 4643. http://dx.doi.org/10.3390/ijerph16234643.

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Health research is important for innovation and assessment of health status and health interventions, and maintaining a strong, engaged cohort of rural health researchers is essential for the ongoing improvement of the health of rural populations. Ethical guidelines and processes ensure research is undertaken in a way that protects and, where possible, empowers participants. We set out to systematically examine and document the challenges posed by ethics and governance processes for rural health researchers in Western Australia (WA) and the impact on the research undertaken. In this qualitative study, fifteen WA-based rural health researchers were interviewed. The identified challenges included inefficient systems, gatekeeping, apparent resistance to research and the lack of research experience of those involved in approval processes. For researchers seeking to conduct studies to improve rural and Aboriginal health, extended delays in approvals can hold up and impede research, ultimately changing the nature of the research undertaken and constraining the willingness of practitioners and researchers to undertake health research. Unwieldy ethics processes were seen to have a particularly onerous impact on rural research pertaining to service delivery, multiple sites, and research involving Aboriginal people, impeding innovation and inquiry in areas where it is much needed.

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Doyle, Kerrie. "Measuring cultural appropriateness of mental health services for Australian Aboriginal peoples in rural and remote Western Australia: a client/clinician's journey." International Journal of Culture and Mental Health 5, no. 1 (April 2012): 40–53. http://dx.doi.org/10.1080/17542863.2010.548915.

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Sims, C., B. Stanley, and E. Milne. "The Frequency of and Indications for General Anaesthesia in Children in Western Australia 2002–2003." Anaesthesia and Intensive Care 33, no. 5 (October 2005): 623–28. http://dx.doi.org/10.1177/0310057x0503300512.

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We conducted a retrospective database search of the Hospital Morbidity Data System at the Health Department of Western Australia to determine the number of anaesthetics given to children aged 16 years or less in Western Australia over a twelve-month period. Information was also collected to assess the types of surgery for which anaesthesia was being provided, and the categories of hospital in which children were being anaesthetized. We found that 28,522 anaesthetics were given to 24,981 children, and 2,462 (9.9%) children had more than one anaesthetic. Five and a half percent of the children in Western Australia had an anaesthetic during the twelve months studied. The most common types of surgery were ear nose and throat (28% of anaesthetics), general (21%), dental/oral procedures (17%) and orthopaedic (15%). There was a bimodal distribution in the incidence of anaesthesia versus age, with peaks at 4 years and at 16 years. The most common category of hospital that children were anaesthetized in was private metropolitan (40%) followed by tertiary (38%), rural (14%) and public metropolitan (8%). One thousand, seven hundred and seven children aged less than one year were given an anaesthetic. These anaesthetics were most frequently given to children in tertiary hospitals (62%) followed by private metropolitan (30%), public metropolitan (6%) and rural hospitals (2%).

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H Lee, Andy, and Jim Codde. "Determinants of length of stay:implications on differential funding for rural and metropolitan hospitals." Australian Health Review 23, no. 4 (2000): 126. http://dx.doi.org/10.1071/ah000126.

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This study analysed and compared the determinants of length of inpatient stay between the rural and metropolitanpublic hospitals. The investigation was based on the 1998/99 Western Australia patient discharge data. A Coxregression model was used due to the high proportion of patient transfers in the rural hospitals. It was found thatseveral variables were associated with length of stay (LOS) variations within Diagnosis Related Groups (DRG). Themethod provides additional insights to hospital management and clinicians in assessing the risk of prolongedhospitalisation. From a state government perspective, a DRG payment adjustment strategy may be developed fordifferent categories of admitted patient episodes. The analysis has implications on the formulation of differentialfunding rates between rural and metropolitan hospitals.

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Kruger, E., and M. Tennant. "A baseline study of the demographics of the oral health workforce in rural and remote Western Australia." Australian Dental Journal 49, no. 3 (September 2004): 136–40. http://dx.doi.org/10.1111/j.1834-7819.2004.tb00062.x.

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Fitts, Michelle S., John Humphreys, Terry Dunbar, Lisa Bourke, Edward Mulholland, Steven Guthridge, Yuejen Zhao, et al. "Understanding and responding to the cost and health impact of short-term health staffing in remote and rural Aboriginal and Torres Strait Islander community-controlled health services: a mixed methods study protocol." BMJ Open 11, no. 8 (August 2021): e043902. http://dx.doi.org/10.1136/bmjopen-2020-043902.

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IntroductionAccess to high-quality primary healthcare is limited for remote residents in Australia. Increasingly, remote health services are reliant on short-term or ‘fly-in, fly-out/drive-in, drive-out’ health workforce to deliver primary healthcare. A key strategy to achieving health service access equity, particularly evident in remote Australia, has been the development of Aboriginal Community Controlled Health Services (ACCHSs). This study aims to generate new knowledge about (1) the impact of short-term staffing in remote and rural ACCHSs on Aboriginal and Torres Strait Islander communities; (2) the potential mitigating effect of community control; and (3) effective, context-specific evidence-based retention strategies.Methods and analysisThis paper describes a 3-year, mixed methods study involving 12 ACCHSs across three states. The methods are situated within an evidence-based programme logic framework for rural and remote primary healthcare services. Quantitative data will be used to describe staffing stability and turnover, with multiple regression analyses to determine associations between independent variables (population size, geographical remoteness, resident staff turnover and socioeconomic status) and dependent variables related to patient care, service cost, quality and effectiveness. Qualitative assessment will include interviews and focus groups with clinical staff, clinic users, regionally-based retrieval staff and representatives of jurisdictional peak bodies for the ACCHS sector, to understand the impact of short-term staff on quality and continuity of patient care, as well as satisfaction and acceptability of services.Ethics and disseminationThe study has ethics approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (project number DR03171), Central Australian Human Research Ethics Committee (CA-19-3493), Western Australian Aboriginal Health Ethics Committee (WAAHEC-938) and Far North Queensland Human Research Ethics Committee (HREC/2019/QCH/56393). Results will be disseminated through peer-reviewed journals, the project steering committee and community/stakeholder engagement activities to be determined by each ACCHS.

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Slaven, Janine, and Stephen Kisely. "STAFF PERCEPTIONS OF CARE FOR DELIBERATE SELF-HARM PATIENTS IN RURAL WESTERN AUSTRALIA: A QUALITATIVE STUDY." Australian Journal of Rural Health 10, no. 5 (June 28, 2008): 233–38. http://dx.doi.org/10.1111/j.1440-1584.2002.tb00037.x.

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McCormack, Julie, Hunna J. Watson, Chris Harris, Julie Potts, and David Forbes. "A hub and spokes approach to building community capacity for eating disorders in rural Western Australia." Australian Journal of Rural Health 21, no. 1 (February 2013): 8–12. http://dx.doi.org/10.1111/ajr.12007.

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Clark, Antony, David B. Preen, Jonathon Q. Ng, James B. Semmens, and C. D'Arcy J. Holman. "Is Western Australia representative of other Australian States and Territories in terms of key socio-demographic and health economic indicators?" Australian Health Review 34, no. 2 (2010): 210. http://dx.doi.org/10.1071/ah09805.

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Objective.To evaluate the extent to which Western Australian (WA) represents the broader Australian population in terms of key socio-demographic and health economic indicators. Methods.We compared key demographic, social and health economic indicators across all Australian States and Territories from Australian government publications in the census years 1991–2006. Jurisdictional averages (JAs) were calculated as the mean (±s.d.) or median (±range). Observed jurisdiction indicators were compared with the JA and ranked according its representativeness of the JA. Results.WA was among the three closest jurisdictions to the national JA for all socio-demographic and health economic indicators examined, with the exception of uptake of private health insurance (ranked 6th) and per-capita health expenditure (ranked 5th). The Northern Territory and Australian Capital Territory were least representative for the majority of indicators. Excluding the proportions of people living in rural or remote areas (0–100%) and of indigenous origin (0.4–28.8%), variations in the indicators across the jurisdictions were relatively small. Conclusions.Population differences between Australia’s States were small, whereas Australia’s Territories were least representative of the JA. WA was the most representative population of Australia’s eight jurisdictions and continues to be in a strong position to contribute to knowledge of the Australian health system that is applicable Australia-wide. What is known about the topic?The Western Australian Data Linkage system (WADLS) is a highly successful and productive research tool that facilitates population-based health research. A potential criticism and concern of this research surrounds the representativeness of the WA population to other Australian States and Territories. Anecdotally, there is a perception that WA’s isolation from other Australian populations may lead to systematic socio-demographic and socioeconomic differences; thus limiting the generalisability of research findings. What does this paper add?This paper compares Australia’s State and Territory population profiles and allows researchers to determine the extent to which contextual issues concerning key socio-demographic and health economic indicators may affect the external validity of population-based research arising from any one jurisdiction. What are the implications to practitioners?In the absence of previous evaluations in this area and with the continued emergence of new data linkage systems around the country, this information is important for health researchers and policy makers who may wish to draw conclusions and make policy decisions that rely upon extrapolating findings from population-based studies.

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Mullan, Leanne, Karen Wynter, Andrea Driscoll, and Bodil Rasmussen. "Barriers and enablers to providing preventative and early intervention diabetes-related foot care: a qualitative study of primary care healthcare professionals' perceptions." Australian Journal of Primary Health 27, no. 4 (2021): 319. http://dx.doi.org/10.1071/py20235.

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This study explored the perceived healthcare system and process barriers and enablers experienced by GPs and Credentialled Diabetes Educators (CDEs) in Australian primary care, in the delivery of preventative and early intervention foot care to people with diabetes. A qualitative design with inductive analysis approach was utilised and reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Semi-structured interviews were conducted with two GPs and 14 CDEs from rural, urban and metropolitan areas of Australia. Participants were from New South Wales, South Australia, Victoria, Western Australia, the Northern Territory and Queensland. Barriers to providing foot care constituted five broad themes: (1) lack of access to footcare specialists and services; (2) education and training insufficiencies; (3) human and physical resource limitations related to funding inadequacies; (4) poor care integration such as inadequate communication and feedback across services and disciplines, and ineffectual multidisciplinary care; and (5) deficient footcare processes and guidelines including ambiguous referral pathways. Enablers to foot care were found at opposing ends of the same spectra as the identified barriers or were related to engaging in mentorship programs and utilising standardised assessment tools. This is the first Australian study to obtain information from GPs and CDEs about the perceived barriers and enablers influencing preventative and early intervention diabetes-related foot care. Findings offer an opportunity for the development and translation of effective intervention strategies across health systems, policy, funding, curriculum and clinical practice, in order to improve outcomes for people with diabetes.

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Hall, Sonya E., C. D'arcy Holman, and Harry Sheiner. "The influence of socio-economic and locational disadvantage on patterns of surgical care for lung cancer in Western Australia 1982-2001." Australian Health Review 27, no. 2 (2004): 68. http://dx.doi.org/10.1071/ah042720068.

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Sonja E Hall is with the School of Population Health, The University of Western Australia.C D'Arcy J Holman is Head, School of Population Health, The University of Western Australia.Harry Sheiner is Chairman, WA Clinical Oncology Group, c/o Cancer Foundation of Western Australia.Objective: Patterns of in-hospital surgical care for lung cancer in Western Australia were examined, including the effects of demographic, locational and socio-economic disadvantage and the possession of private health insurance, on the likelihood of receiving surgeryPatients and methods: The WA Record Linkage Project was used to extract hospital morbidity, cancer and death records of all people with lung cancer in Western Australia from 1982 to 2001. The likelihood of receiving lung cancer surgery was estimated, after adjustment for co-variates, using logistic regression.Results: Overall, 16% of patients received surgery for their lung cancer, although this varied according to histology. Patients who received surgery were typically younger, female, non-indigenous and had less comorbidity. Patients from socio-economically disadvantaged groups tended to be less likely to receive surgery (OR 0.79; 95% CI 0.61-1.04) although this was not significant for each category of disadvantage. Those who had their first hospital admission, with a mention of lung cancer, in a rural hospital were less likely to receive surgery (OR 0.26; 95% CI 0.19-0.36) than those in metropolitan hospitals, although residential location generally had less effect (OR 0.36; 95% CI 0.14-0.92). Patients admitted as a private patient either to a private or public hospital for their first mention of lung cancer had increased likelihood of receiving surgery (OR 1.15; 95% CI 1.02-1.30); however first admission to a private hospital had no effect (OR 0.99: 95% CI 0.85-1.16).Conclusion: The utilisation of lung cancer surgery was low with several factors found to affect the rate. Patients from socio-economically or locationally disadvantaged backgrounds, indigenous patients or patients without private health insurance were less likely to receive lung cancer surgery than those from more advantaged groups.

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Journal articles on the topic 'Rural health – Western Australia'

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