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Published in: Human Resources for Health 1/2017

Open Access 01-12-2017 | Research

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study

Authors: Belinda G. O’Sullivan, Matthew R. McGrail, Johannes U. Stoelwinder

Published in: Human Resources for Health | Issue 1/2017

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Abstract

Background

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations.

Methods

A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest.

Results

Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%).

Conclusions

Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist’s main practice is likely to support participation and improve service distribution.
Literature
1.
go back to reference Banu T, Chowdhury TK, Kabir M, Talukder R, Lakhoo K. Bringing surgery to rural children: Chittagong, Bangladesh experience. World J Surg. 2013;37:730–6.CrossRefPubMed Banu T, Chowdhury TK, Kabir M, Talukder R, Lakhoo K. Bringing surgery to rural children: Chittagong, Bangladesh experience. World J Surg. 2013;37:730–6.CrossRefPubMed
3.
go back to reference Canadian Health Services Research Foundation. Evidence boost for quality: visiting-specialist services to improve access and outcomes for isolated populations. Healthc Policy. 2008;3:78–82.PubMedCentral Canadian Health Services Research Foundation. Evidence boost for quality: visiting-specialist services to improve access and outcomes for isolated populations. Healthc Policy. 2008;3:78–82.PubMedCentral
5.
go back to reference Aboagye JK, Kaiser HE, Hayanga AJ. Rural-urban differences in access to specialist providers of colorectal cancer care in the United States: a physician workforce issue. JAMA Surg. 2014;149:537–43.CrossRefPubMed Aboagye JK, Kaiser HE, Hayanga AJ. Rural-urban differences in access to specialist providers of colorectal cancer care in the United States: a physician workforce issue. JAMA Surg. 2014;149:537–43.CrossRefPubMed
6.
go back to reference Winters R, Pou A, Friedlander P. A “medical mission” at home: the needs of rural America in terms of otolaryngology care. J Rural Health. 2011;27:297–301.CrossRefPubMed Winters R, Pou A, Friedlander P. A “medical mission” at home: the needs of rural America in terms of otolaryngology care. J Rural Health. 2011;27:297–301.CrossRefPubMed
9.
go back to reference Shi G, Zhou B, Cai Z, Wu T, Li X, Xu W. Referral by outreach specialist reduces hospitalisation costs of rural patients with digestive tract cancer: a report from medical consortium in China. Rural Remote Health (Online). 2014;14:1–10. Shi G, Zhou B, Cai Z, Wu T, Li X, Xu W. Referral by outreach specialist reduces hospitalisation costs of rural patients with digestive tract cancer: a report from medical consortium in China. Rural Remote Health (Online). 2014;14:1–10.
10.
go back to reference Finger RP, Kupitz DG, Holz FG, Chandrasekhar S, Balasubramaniam B, Ramani RV, Gilbert CE. Regular provision of outreach increases acceptance of cataract surgery in South India. Tropical Med Int Health. 2011;16:1268–75.CrossRef Finger RP, Kupitz DG, Holz FG, Chandrasekhar S, Balasubramaniam B, Ramani RV, Gilbert CE. Regular provision of outreach increases acceptance of cataract surgery in South India. Tropical Med Int Health. 2011;16:1268–75.CrossRef
11.
go back to reference Gruen RL, Bailie RS, Wang Z, Heard S, O’Rourke IC. Specialist outreach to isolated and disadvantaged communities: a population-based study. Lancet. 2006;368:130–8.CrossRefPubMed Gruen RL, Bailie RS, Wang Z, Heard S, O’Rourke IC. Specialist outreach to isolated and disadvantaged communities: a population-based study. Lancet. 2006;368:130–8.CrossRefPubMed
12.
go back to reference Uhlman MA, Gruca TS, Tracy R, Bing MT, Erickson BA. Improving access to urologic care for rural populations through outreach clinics. Urology. 2013;82:1272–6.CrossRefPubMed Uhlman MA, Gruca TS, Tracy R, Bing MT, Erickson BA. Improving access to urologic care for rural populations through outreach clinics. Urology. 2013;82:1272–6.CrossRefPubMed
13.
go back to reference Gruca TS, Nam I, Tracy R. Trends in medical oncology outreach clinics in rural areas. J Oncol Pract. 2014;10:e313–20.CrossRefPubMed Gruca TS, Nam I, Tracy R. Trends in medical oncology outreach clinics in rural areas. J Oncol Pract. 2014;10:e313–20.CrossRefPubMed
14.
go back to reference O’Sullivan B, Joyce C, McGrail M. Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution. Hum Resour Health. 2014;12:1–10.CrossRef O’Sullivan B, Joyce C, McGrail M. Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution. Hum Resour Health. 2014;12:1–10.CrossRef
15.
go back to reference Drew J, Cashman SB, Savageau JA, Stenger J. The visiting specialist model of rural health care delivery: a survey in Massachusetts. J Rural Health. 2006;22:294–9.CrossRefPubMed Drew J, Cashman SB, Savageau JA, Stenger J. The visiting specialist model of rural health care delivery: a survey in Massachusetts. J Rural Health. 2006;22:294–9.CrossRefPubMed
16.
go back to reference Tibby D, Corpus R, Walters DL. Establishment of an innovative specialist cardiac indigenous outreach service in rural and remote Queensland. Heart Lung Circ. 2010;19:361–6.CrossRefPubMed Tibby D, Corpus R, Walters DL. Establishment of an innovative specialist cardiac indigenous outreach service in rural and remote Queensland. Heart Lung Circ. 2010;19:361–6.CrossRefPubMed
17.
go back to reference Hoy W, Kondalsamy-Chennakesavan S, Scheppingen J, Sharma S, Katz I. A chronic disease outreach program for Aboriginal communities. Kidney Int. 2005;68:S76–82.CrossRef Hoy W, Kondalsamy-Chennakesavan S, Scheppingen J, Sharma S, Katz I. A chronic disease outreach program for Aboriginal communities. Kidney Int. 2005;68:S76–82.CrossRef
18.
19.
go back to reference Rothstein J, Haezelwood R, Fraser M. Health of Aboriginal and Torres Strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service. Med J Aust. 2007;186:519–21.PubMed Rothstein J, Haezelwood R, Fraser M. Health of Aboriginal and Torres Strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service. Med J Aust. 2007;186:519–21.PubMed
21.
go back to reference Cord-Udy N. The medical specialist outreach assistance programme in South Australia. Australas Psychiatry. 2003;11:189–94.CrossRef Cord-Udy N. The medical specialist outreach assistance programme in South Australia. Australas Psychiatry. 2003;11:189–94.CrossRef
22.
go back to reference Chittleborough T, Lourensz K, Elliot M, Thomas P, Franzi S. Outreach surgical consulting services in North East Victoria. Aust J Rural Health. 2013;21:325–8.CrossRefPubMed Chittleborough T, Lourensz K, Elliot M, Thomas P, Franzi S. Outreach surgical consulting services in North East Victoria. Aust J Rural Health. 2013;21:325–8.CrossRefPubMed
23.
go back to reference Joyce C, Scott A, Jeon S-H, Humphreys J, Kalb G, Witt J, Leahy A. The “Medicine in Australia: Balancing Employment and Life (MABEL)” longitudinal survey—protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res. 2010;10:1–10.CrossRef Joyce C, Scott A, Jeon S-H, Humphreys J, Kalb G, Witt J, Leahy A. The “Medicine in Australia: Balancing Employment and Life (MABEL)” longitudinal survey—protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res. 2010;10:1–10.CrossRef
26.
go back to reference Yan W, Cheng TC, Scott A, Joyce CM, Humphreys J, Kalb G, Leahy A. Medicine in Australia: Balancing Employment and Life (MABEL). Aust Econ Rev. 2011;44:102–12.CrossRef Yan W, Cheng TC, Scott A, Joyce CM, Humphreys J, Kalb G, Leahy A. Medicine in Australia: Balancing Employment and Life (MABEL). Aust Econ Rev. 2011;44:102–12.CrossRef
29.
go back to reference Taylor H, Fox S, Xie J, Dunn R, Arnold A, Keeffe J. The prevalence of trachoma in Australia: the National Indigenous Eye Health Survey. Med J Aust. 2010;192:248–53.PubMed Taylor H, Fox S, Xie J, Dunn R, Arnold A, Keeffe J. The prevalence of trachoma in Australia: the National Indigenous Eye Health Survey. Med J Aust. 2010;192:248–53.PubMed
30.
go back to reference Cheng TC, Joyce CM, Scott A. An empirical analysis of public and private medical practice in Australia. Health Policy. 2013;111:43–51.CrossRefPubMed Cheng TC, Joyce CM, Scott A. An empirical analysis of public and private medical practice in Australia. Health Policy. 2013;111:43–51.CrossRefPubMed
32.
go back to reference StataCorp. Stata data analysis and statistical software. 2009. StataCorp. Stata data analysis and statistical software. 2009.
33.
go back to reference Hancock C, Steinbach A, Nesbitt TS, Adler SR, Auerswald CL. Why doctors choose small towns: a developmental model of rural physician recruitment and retention. Soc Sci Med. 2009;69(9):1368–76.CrossRefPubMed Hancock C, Steinbach A, Nesbitt TS, Adler SR, Auerswald CL. Why doctors choose small towns: a developmental model of rural physician recruitment and retention. Soc Sci Med. 2009;69(9):1368–76.CrossRefPubMed
34.
go back to reference Medlin LG, Chang AB, Fong K, Jackson R, Bishop P, Dent A, Hill DC, Vincent S, O’Grady K-AF. Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia. Aust Health Rev. 2014;38:447–53.CrossRefPubMed Medlin LG, Chang AB, Fong K, Jackson R, Bishop P, Dent A, Hill DC, Vincent S, O’Grady K-AF. Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia. Aust Health Rev. 2014;38:447–53.CrossRefPubMed
35.
go back to reference O’Sullivan B, McGrail M, Joyce C, Stoelwinder J. Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study. Australian Health Review (published online, 21 September 2015). http://dx.doi.org/10.1071/AH15100. Accessed 8 Nov 2016. O’Sullivan B, McGrail M, Joyce C, Stoelwinder J. Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study. Australian Health Review (published online, 21 September 2015). http://​dx.​doi.​org/​10.​1071/​AH15100. Accessed 8 Nov 2016.
Metadata
Title
Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study
Authors
Belinda G. O’Sullivan
Matthew R. McGrail
Johannes U. Stoelwinder
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2017
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-016-0174-z

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