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Beattie J, Binder M, Fuller L. Rural longitudinal integrated clerkships and medical workforce outcomes: A scoping review. MEDICAL TEACHER 2024; 46:545-555. [PMID: 37769044 DOI: 10.1080/0142159x.2023.2260082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Internationally the medical workforce is suffering from a persistent geographic and specialist maldistribution. Longitudinal models of rural medical education such as longitudinal integrated clerkships (LIC) have been one of the strategies employed to redress this issue. AIM To map and synthesise the evidence on the medical workforce outcomes of rural LIC graduates, identifying gaps in the literature to inform future research. METHODS This review followed Arksey and O'Malley's methodological steps. Databases searched included Medline, CINAHL Complete (EBSCOhost), Scopus, Embase (Elsevier), and ISI Web of Science. RESULTS A total of 9045 non-duplicate articles were located, 112 underwent a full review, with 25 articles meeting the inclusion criteria. Studies were commonly cohort-based (84%), with data collected by database tracking and data linkage (52%). Five themes were identified to summarise the studies: (i) Overall geographic workforce outcomes (ii) influence of non-LIC medical training, (iii) remaining in region and level of rurality, (iv) medical speciality choice and rurality, and (v) selection and preferences. CONCLUSION Synthesis of the evidence related to workforce outcomes of rural LIC graduates provides directions for future rural medical workforce planning and research. While rural LIC graduates were found to be more likely to work rurally and in primary care specialities compared to graduates from other training pathways there is evidence to suggest this can be enhanced by strategically aligning selection and training factors.
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Affiliation(s)
- Jessica Beattie
- School of Medicine, Rural Community Clinical School, Deakin University, Colac, Australia
| | - Marley Binder
- School of Medicine, University Department of Rural Health, Deakin University, Warrnambool, Australia
| | - Lara Fuller
- School of Medicine, Rural Community Clinical School, Deakin University, Colac, Australia
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Tesfaye W, Krass I, Sud K, Johnson DW, Van C, Versace VL, McMorrow R, Fethney J, Mullan J, Tran A, Robson B, Vagholkar S, Kairaitis L, Gisev N, Fathima M, Tong V, Coric N, Castelino RL. Impact of a pharmacy-led screening and intervention in people at risk of or living with chronic kidney disease in a primary care setting: a cluster randomised trial protocol. BMJ Open 2023; 13:e079110. [PMID: 38128937 DOI: 10.1136/bmjopen-2023-079110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is increasingly recognised as a growing global public health problem. Early detection and management can significantly reduce the loss of kidney function. The proposed trial aims to evaluate the impact of a community pharmacy-led intervention combining CKD screening and medication review on CKD detection and quality use of medicines (QUM) for patients with CKD. We hypothesise that the proposed intervention will enhance detection of newly diagnosed CKD cases and reduce potentially inappropriate medications use by people at risk of or living with CKD. METHODS AND ANALYSIS This study is a multicentre, pragmatic, two-level cluster randomised controlled trial which will be conducted across different regions in Australia. Clusters of community pharmacies from geographical groups of co-located postcodes will be randomised. The project will be conducted in 122 community pharmacies distributed across metropolitan and rural areas. The trial consists of two arms: (1) Control Group: a risk assessment using the QKidney CKD risk assessment tool, and (2) Intervention Group: a risk assessment using the QKidney CKD plus Point-of-Care Testing for kidney function markers (serum creatinine and estimated glomerular filtration rate), followed by a QUM service. The primary outcomes of the study are the proportion of patients newly diagnosed with CKD at the end of the study period (12 months); and rates of changes in the number of medications considered problematic in kidney disease (number of medications prescribed at inappropriate doses based on kidney function and/or number of nephrotoxic medications) over the same period. Secondary outcomes include proportion of people on potentially inappropriate medications, types of recommendations provided by the pharmacist (and acceptance rate by general practitioners), proportion of people who were screened, referred, and took up the referral to visit their general practitioners, and economic and other patient-centred outcomes. ETHICS AND DISSEMINATION The trial protocol has been approved by the Human Research Ethics Committee at the University of Sydney (2022/044) and the findings of the study will be presented at scientific conferences and published in peer-reviewed journal(s). TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12622000329763).
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Affiliation(s)
- Wubshet Tesfaye
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Ines Krass
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Kamal Sud
- Nepean Kidney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, New South Wales, Australia
- The University of Sydney School of Medicine, Sydney, New South Wales, Australia
| | - David W Johnson
- Centre for Health Services Research, The University of Queensland Faculty of Medicine, Brisbane, Queensland, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Connie Van
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Rita McMorrow
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Judith Fethney
- School of Nursing, The University of Sydney Susan Wakil School of Nursing and Midwifery, Sydney, New South Wales, Australia
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anh Tran
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Sanjyot Vagholkar
- MQ Health General Practice, Macquarie University, Sydney, New South Wales, Australia
| | - Lukas Kairaitis
- Department of Renal Medicine, Blacktown Hospital, Sydney, New South Wales, Australia
- Western Sydney University School of Medicine, Sydney, New South Wales, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Mariam Fathima
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Vivien Tong
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Natali Coric
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ronald L Castelino
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
- Pharmacy Department, Blacktown Hospital, Sydney, New South Wales, Australia
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Cortie CH, Garne D, Parker-Newlyn L, Ivers RG, Mullan J, Mansfield KJ, Bonney A. An automated protocol for assessing career rurality outcomes of Australian health professionals using retrospective data. Aust J Rural Health 2023; 31:1252-1260. [PMID: 37859332 DOI: 10.1111/ajr.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/28/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Addressing the imbalance of the health workforce between metropolitan and rural areas requires a clear understanding of trends in choices of work location of health care staff. OBJECTIVE Here, we provide an automated and highly reproducible protocol to examine the location of health care workers over multiple years using medical graduates as a case study. DESIGN Data linkage cohort study. The study cohort examined was University of Wollongong Medical graduates from 2010 to 2021 who were registered to practice in Australia. The main outcome measure was graduate location of practice in Modified Monash regsions MM1 or MM2-7 across multiple postgraduate years. This protocol used R Markdown. FINDINGS An automated and reproducible protocol was used to analyse choices of work location for the University of Wollongong's medical graduates. Over 90% of graduates were registered with AHPRA. Around 25%-30% of graduates were found to work in MM2-7 regions across their careers, exceeding the national average. DISCUSSION The protocol presented allows for a fast and reproducible analysis of work location by region for health care workers. This will allow comparisons of outcomes between universities or health professions.
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Affiliation(s)
- Colin H Cortie
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - David Garne
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Lyndal Parker-Newlyn
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Rowena G Ivers
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Kylie J Mansfield
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Andrew Bonney
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
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Kavanagh BE, Corney KB, Beks H, Williams LJ, Quirk SE, Versace VL. A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia. BMC Health Serv Res 2023; 23:1060. [PMID: 37794469 PMCID: PMC10552307 DOI: 10.1186/s12913-023-10034-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context. METHODS A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted. RESULTS Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed. CONCLUSION Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.
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Affiliation(s)
- Bianca E Kavanagh
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia.
| | - Kayla B Corney
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Hannah Beks
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
| | - Lana J Williams
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Shae E Quirk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
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Beks H, Clayden S, Versace VL. Translating aspects of The National Rural and Remote Nursing Generalist Framework 2023-2027 into practice: opportunities and considerations. AUST HEALTH REV 2023; 47:626-628. [PMID: 37574253 DOI: 10.1071/ah23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
Reforms that grow the capabilities of the health workforce are critical to improving outcomes for populations residing in rural and remote areas of Australia. Nurses are central to improving the accessibility of health care for populations in these areas. The Australian Government's recent release of The National Rural and Remote Nursing Generalist Framework 2023-2027 is timely for identifying opportunities to strengthen the rural and remote nursing workforce. Further consideration of how the nursing workforce can be supported to translate aspects of the framework into practice is required. To achieve this, it is necessary to identify strategies to support registered nurses to develop capabilities stipulated within the framework. A logical vehicle for this translation is through the continued support of the Australian Government's Rural Health Multidisciplinary Training program, which includes an established network of 19 University Departments of Rural Health. Leveraging from this national network that is geographically expansive and has a long-term strategic impetus for growing the rural and remote nursing workforce, provides an opportunity for translating aspects of the framework at a national scale.
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Affiliation(s)
- H Beks
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia
| | - S Clayden
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia; and Specialist Physicians Clinic, South West Healthcare, Warrnambool, Vic., Australia
| | - V L Versace
- Deakin Rural Health, School of Medicine, Warrnambool, Vic., Australia
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Walsh SM, Versace VL, Thompson SC, Browne LJ, Knight S, Lyle DM, Argus G, Jones M. Supporting nursing and allied health student placements in rural and remote Australia: a narrative review of publications by university departments of rural health. Med J Aust 2023; 219 Suppl 3:S14-S19. [PMID: 37544003 DOI: 10.5694/mja2.52032] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 08/08/2023]
Abstract
University departments of rural health are Commonwealth-funded to improve recruitment and retention of the rural allied health and nursing (including midwifery) workforce, primarily through student placements. We examined publications by university departments of rural health that were focused on allied health and nursing students undertaking placements in rural Australia, to understand the characteristics, main findings and implications of the research conducted. Interprofessional learning was a key feature of placements and placement education, although other activities such as community engagement added to placement experiences. Factors such as quality supervision and being involved in the community contributed to a positive placement experience and increased rural practice intention. Tracking studies showed a relationship between rural placements, rural practice intention and rural practice. Rural placements occurred across a variety of settings and in locations consistent with the policy framework. Embedding university departments of rural health in rural communities enabled staff to build relationships and increase placement capacity.
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Affiliation(s)
- Sandra M Walsh
- Department of Rural Health, University of South Australia, Whyalla, SA
| | | | - Sandra C Thompson
- Western Australia Centre for Rural Health, University of Western Australia, Geraldton, WA
| | - Leanne J Browne
- Department of Rural Health, University of Newcastle, Tamworth, NSW
| | - Sabina Knight
- Central Queensland Centre for Rural and Remote Health, James Cook University, Emerald, QLD
| | - David M Lyle
- Broken Hill University Department of Rural Health, University of Sydney, Broken Hill, NSW
| | - Geoff Argus
- Southern Queensland Rural Health, University of Queensland, Toowoomba, QLD
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla, SA
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Alston L, Nichols M, Allender S, Versace V, Brown LJ, Schumacher T, Howard G, Shikany JM, Bolton KA, Livingstone K, Zorbas C, Judd SE. Dietary patterns in rural and metropolitan Australia: a cross-sectional study exploring dietary patterns, inflammation and association with cardiovascular disease risk factors. BMJ Open 2023; 13:e069475. [PMID: 37270193 DOI: 10.1136/bmjopen-2022-069475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES This study sought first to empirically define dietary patterns and to apply the novel Dietary Inflammation Score (DIS) in data from rural and metropolitan populations in Australia, and second to investigate associations with cardiovascular disease (CVD) risk factors. DESIGN Cross-sectional study. SETTING Rural and metropolitan Australia. PARTICIPANTS Adults over the age of 18 years living in rural or metropolitan Australia who participated in the Australian Health survey. PRIMARY OUTCOMES A posteriori dietary patterns for participants separated into rural and metropolitan populations using principal component analysis. SECONDARY OUTCOMES association of each dietary pattern and DIS with CVD risk factors was explored using logistic regression. RESULTS The sample included 713 rural and 1185 metropolitan participants. The rural sample was significantly older (mean age 52.7 compared with 48.6 years) and had a higher prevalence of CVD risk factors. Two primary dietary patterns were derived from each population (four in total), and dietary patterns were different between the rural and metropolitan areas. None of the identified patterns were associated with CVD risk factors in metropolitan or rural areas, aside diet pattern 2 being strongly associated with from self-reported ischaemic heart disease (OR 13.90 95% CI 2.29 to 84.3) in rural areas. There were no significant differences between the DIS and CVD risk factors across the two populations, except for a higher DIS being associated with overweight/obesity in rural areas. CONCLUSION Exploration of dietary patterns between rural and metropolitan Australia shows differences between the two populations, possibly reflective of distinct cultures, socioeconomic factors, geography, food access and/or food environments in the different areas. Our study provides evidence that action targeting healthier dietary intakes needs to be tailored to rurality in the Australian context.
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Affiliation(s)
- Laura Alston
- Deakin Rural Health, Deakin University, Warnambool, Victoria, Australia
- Research Unit, Colac Area Health, Colac, Victoria, Australia
| | - Melanie Nichols
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, Deakin University, Warnambool, Victoria, Australia
| | - Leanne J Brown
- Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy Schumacher
- Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - George Howard
- Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, UK
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
| | - Kristy A Bolton
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Katherine Livingstone
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Christina Zorbas
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Suzanne E Judd
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
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Wood SM, Alston L, Beks H, Mc Namara K, Coffee NT, Clark RA, Wong Shee A, Versace VL. The application of spatial measures to analyse health service accessibility in Australia: a systematic review and recommendations for future practice. BMC Health Serv Res 2023; 23:330. [PMID: 37005659 PMCID: PMC10066971 DOI: 10.1186/s12913-023-09342-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/27/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Australia's inequitable distribution of health services is well documented. Spatial access relates to the geographic limitations affecting the availability and accessibility of healthcare practitioners and services. Issues associated with spatial access are often influenced by Australia's vast landmass, challenging environments, uneven population concentration, and sparsely distributed populations in rural and remote areas. Measuring access contributes to a broader understanding of the performance of health systems, particularly in rural/remote areas. This systematic review synthesises the evidence identifying what spatial measures and geographic classifications are used and how they are applied in the Australian peer-reviewed literature. METHODS A systematic search of peer-reviewed literature published between 2002 and 2022 was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Search terms were derived from three major topics, including: [1] Australian population; [2] spatial analysis of health service accessibility; and [3] objective physical access measures. RESULTS Database searches retrieved 1,381 unique records. Records were screened for eligibility, resulting in 82 articles for inclusion. Most articles analysed access to primary health services (n = 50; 61%), followed by specialist care (n = 17; 21%), hospital services (n = 12; 15%), and health promotion and prevention (n = 3; 4%). The geographic scope of the 82 articles included national (n = 33; 40%), state (n = 27; 33%), metropolitan (n = 18; 22%), and specified regional / rural /remote area (n = 4; 5%). Most articles used distance-based physical access measures, including travel time (n = 30; 37%) and travel distance along a road network (n = 21; 26%), and Euclidean distance (n = 24; 29%). CONCLUSION This review is the first comprehensive systematic review to synthesise the evidence on how spatial measures have been applied to measure health service accessibility in the Australian context over the past two decades. Objective and transparent access measures that are fit for purpose are imperative to address persistent health inequities and inform equitable resource distribution and evidence-based policymaking.
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Affiliation(s)
- Sarah M Wood
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia.
| | - Laura Alston
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
- Research Unit, Colac Area Health, Colac, Vic, Australia
| | - Hannah Beks
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
| | - Kevin Mc Namara
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
- Grampians Health, Ballarat, Vic, Australia
| | - Neil T Coffee
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
- University of Canberra, Canberra, ACT, Australia
| | - Robyn A Clark
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Anna Wong Shee
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
- Grampians Health, Ballarat, Vic, Australia
| | - Vincent L Versace
- School of Medicine, Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia
- Grampians Health, Ballarat, Vic, Australia
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Puah LS, Gillam M, Walsh S, Jones M, Yisma E. Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia? Aust J Rural Health 2023. [PMID: 36852747 DOI: 10.1111/ajr.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. DESIGN Cross-sectional study. PARTICIPANTS Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. MAIN OUTCOME MEASURES Principal place of practice at first and third years after graduation. RESULTS In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. CONCLUSIONS Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.
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Affiliation(s)
- Lee San Puah
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Engida Yisma
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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Beks H, Mitchell F, Charles J, McNamara K, Versace V. An Aboriginal Community-Controlled Health Organization model of service delivery: qualitative process evaluation of the Tulku wan Wininn mobile clinic. Int J Equity Health 2022; 21:163. [PMID: 36384739 PMCID: PMC9667861 DOI: 10.1186/s12939-022-01768-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mobile clinics have been implemented in diverse clinical and geographical settings to provide proximal health care for specific populations. Primary health care mobile clinics have been implemented widely for Indigenous populations, with a paucity of research evaluations around service delivery models internationally. To redress factors impeding service accessibility for Aboriginal and Torres Strait Islander Peoples, Budja Budja Aboriginal Cooperative (Aboriginal Community Controlled Health Organisation located in a small rural town in Victoria, Australia), developed and implemented the Tulku wan Wininn primary health mobile clinic. METHODS A qualitative process evaluation methodology was used to explore contextual factors mediating the implementation of the mobile clinic, including the acceptability of the service to health service personnel, external key informants, and Aboriginal and/or Torres Strait Islander clients. A synthesis of international ethical guidelines, (Consolidated Criteria for strengthening reporting of health research involving Indigenous peoples (CONSIDER statement), was prospectively applied to shape the study design and research process. Semi-structured interviews were conducted with participants. Data collection occurred from July 2019 to October 2021. Inductive thematic data analysis was undertaken concurrently with data collection. RESULTS Data was collected from 19 participants which included 12 health service personnel and key informants, and 7 Aboriginal clients. In total, data from 22 interviews were included as interviews with three clients were undertaken twice. Four themes were developed: considerations for early implementation, maintaining face-to-face services during COVID-19, acceptability as a model of service delivery, and maintaining the mobile clinic as a service delivery model. CONCLUSION Evidence supporting the acceptability of a primary health care mobile clinic for Aboriginal Peoples residing in rural Victoria is provided. Despite the experience of early implementation challenges and adaptations, the mobile clinic addressed known transport and cultural barriers to accessing primary health care services. In the context of COVID-19 lockdowns, the mobile clinic was valued for the provision of face-to-face care for Aboriginal clients. Key issues for maintaining the mobile clinic include health workforce and funding. Findings are of value to other organizations seeking to implement a primary health mobile clinic service delivery model to redress barriers to accessibility experienced by the communities they serve.
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Affiliation(s)
- H. Beks
- Deakin Rural Health, School of Medicine, Warrnambool, Victoria Australia
| | - F. Mitchell
- Deakin Rural Health, School of Medicine, Warrnambool, Victoria Australia
| | - J.A. Charles
- grid.1022.10000 0004 0437 5432First Peoples Health Unit, Health Group, Griffith University, Queensland, Australia
| | - K.P. McNamara
- Deakin Rural Health, School of Medicine, Warrnambool, Victoria Australia
| | - V.L. Versace
- Deakin Rural Health, School of Medicine, Warrnambool, Victoria Australia
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Seaman CE, Green E, Freire K. Effect of Rural Clinical Placements on Intention to Practice and Employment in Rural Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5363. [PMID: 35564758 PMCID: PMC9099894 DOI: 10.3390/ijerph19095363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Supporting the provision of clinical placement (CP) experiences in rural areas is a strategy used worldwide to promote the rural health workforce. While there is international evidence for this intervention in medicine, there is limited understanding of the influence of rural CP for nursing, midwifery, allied health, and dentistry health professions in Australia, which have received substantial federal investment. This review examined the relationship between rural CP and non-medicine health students' future rural practice intentions and workforce outcomes. METHODS Four databases were systematically searched; papers were screened using defined criteria and appraised using the mixed-methods appraisal tool (MMAT). Findings were synthesized using a critical narrative approach. RESULTS The methodological quality of the 29 eligible studies (13 quantitative non-randomized, 10 mixed method, 4 qualitative, 2 quantitative description) was appraised. Ten high-quality studies were identified. The review found that positive CP experiences may influence intention to practice rurally amongst undecided students and serve as a reinforcing experience for those students already interested in rural practice. There were mixed findings regarding the influence of CP length. The review also found that there is currently only evidence for the short-term effects of CP on students' future practice outcomes in rural areas with focus thus far on early practice outcomes. CONCLUSIONS Those looking to use rural CP to promote the rural health workforce should focus on supporting the quality of a large number of CP experiences that are undertaken in rural areas, as there are currently differing findings on the role of rural CP length. Future studies of rural CP should consider greater use of social and educational theories to guide them.
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Affiliation(s)
- Claire Ellen Seaman
- Three Rivers Department of Rural Health, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (E.G.); (K.F.)
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