Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study

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Abstract

Objective. This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations.

Methods. The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive
models of rural outreach were studied.

Results. Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In
comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95%
CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately.

Conclusions. Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services.
Original languageEnglish
Pages (from-to)330 - 336
Number of pages7
JournalAustralian Health Review
Volume40
Issue number3
Publication statusPublished - 2016

Cite this

@article{ef728a0ac71d4e83a91e3efdcb3474b8,
title = "Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study",
abstract = "Objective. This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations.Methods. The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusivemodels of rural outreach were studied.Results. Nearly half of the outreach services (585/1401; 42{\%}) were provided to outer regional or remote locations, most (58{\%}) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42{\%}). Incomparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95{\%} confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95{\%}CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately.Conclusions. Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services.",
author = "O'Sullivan, {Belinda Gabrielle} and McGrail, {Matthew Richard} and Joyce, {Catherine Marie} and Stoelwinder, {Johannes Uiltje}",
year = "2016",
language = "English",
volume = "40",
pages = "330 -- 336",
journal = "Australian Health Review",
issn = "0156-5788",
publisher = "CSIRO Publishing",
number = "3",

}

TY - JOUR

T1 - Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study

AU - O'Sullivan, Belinda Gabrielle

AU - McGrail, Matthew Richard

AU - Joyce, Catherine Marie

AU - Stoelwinder, Johannes Uiltje

PY - 2016

Y1 - 2016

N2 - Objective. This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations.Methods. The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusivemodels of rural outreach were studied.Results. Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). Incomparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95%CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately.Conclusions. Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services.

AB - Objective. This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations.Methods. The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusivemodels of rural outreach were studied.Results. Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). Incomparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95%CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately.Conclusions. Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services.

UR - http://www.publish.csiro.au.ezproxy.lib.monash.edu.au/nid/270/paper/AH15100.htm

M3 - Article

VL - 40

SP - 330

EP - 336

JO - Australian Health Review

JF - Australian Health Review

SN - 0156-5788

IS - 3

ER -