Rural Remote Health
-
Rural Remote Health · Jul 2015
ReviewThe Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.
Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. ⋯ Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.
-
Rural Remote Health · Jul 2015
ReviewCommunicable diseases in rural and remote Australia: the need for improved understanding and action.
Rural and remote communities of Australia, particularly those including Aboriginal people, experience greater morbidity and mortality across a range of health outcomes compared to urban communities. Previous national data have demonstrated that rural and remote communities experience a disproportionate burden of communicable diseases compared to their urban counterparts. This systematic review was undertaken to describe the types of research that have explored the epidemiology of communicable diseases in rural and remote communities in Australia, with particular reference to the social determinants of health. ⋯ This systematic review identified several communicable diseases that continue to cause considerable morbidity in remote Aboriginal communities, including skin, eye and respiratory infections, particularly for children. Overall there is a substantial amount of descriptive epidemiology published, but few analytical or experimental studies. Despite a lack of empirical investigation into the social determinants of the burden of communicable disease, there is emerging evidence that has demonstrated a significant association between housing conditions and skin, ear, respiratory and gastrointestinal infections in children. There is also growing recognition of other social and environmental factors that can influence the burden of diseases in rural and remote communities. Further investment into higher quality community-based research that addresses the social determinants of communicable diseases in remote communities is warranted. The lack of research investigating zoonoses and tropical diseases was noted.
-
Rural Remote Health · Jul 2015
Comparative StudyImpact of rurality on maternal and infant health indicators and outcomes in Maine.
Rural residents may face health challenges related to geographic barriers to care, physician shortages, poverty, lower educational attainment, and other demographic factors. In maternal and child health, these disparities may be evidenced by the health risks and behaviors of new mothers, the health of infants born to these mothers, and the care received by both mothers and infants. ⋯ These results show that, while rural women face significant demographic and behavior challenges, their access to prenatal care, the care they receive while pregnant, and the outcomes of their pregnancies are similar to those of urban women. These results highlight areas where focused pre-pregnancy and prenatal education may improve maternal and child health in rural Maine.
-
Rural Remote Health · Jul 2015
ReviewSuccesses, challenges and needs regarding rural health medical education in continental Central America: a literature review and narrative synthesis.
Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. ⋯ Expertise in rural medicine and training exists in continental Central America. However, there are numerous challenges to improving medical education to meet the needs of rural communities. Overcoming these challenges will require creative solutions, new partnerships, and evaluation and dissemination of successful educational programs. There is a great need for further research on this topic.
-
Rural Remote Health · Jul 2015
ReviewDeterminants of an urban origin student choosing rural practice: a scoping review.
The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. ⋯ Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation. Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.