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Metropolitan Setting (metropolitan + setting)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Recruitment and Retention of Rural Physicians: Outcomes From the Rural Physician Associate Program of Minnesota

THE JOURNAL OF RURAL HEALTH, Issue 4 2008
Gwen Wagstrom Halaas MD
ABSTRACT:,Context: Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. Purpose: To examine RPAP outcomes in recruiting and retaining rural primary care physicians. Methods: The RPAP database, including moves and current practice settings, was examined using descriptive statistics. Findings: On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. Conclusion: RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting. [source]

Costs of accessing surgical specialists by rural and remote residents

ANZ JOURNAL OF SURGERY, Issue 9 2001
Sarah L. Rankin
Introduction: Access to surgical specialist services by rural and remote residents in Australia is limited. Little information is available on the cost to rural residents of accessing specialist treatment. The aim of the present study was to define the personal costs incurred by country patients in Western Australia when accessing specialist surgical services in a rural or metropolitan setting. Methods: A random sample of 50 patients who attended a visiting rural surgical service between December 1998 and February 1999 inclusive was recruited. In a structured telephone interview patients were asked 40 non-clinical questions relating to their recent specialist consultation. The cost of accessing these services was determined from time lost from work, distance and travel expenses. The same formula was then applied to estimate the cost of attending a base metropolitan hospital. The need for an accompanying person was determined from a subset of 16 patients who had transferred to metropolitan specialist consultation in the previous 12 months. Average waiting list times for consultations and common surgical procedures for the visiting service were compared with those for a metropolitan-based service. Results: An estimated saving of AU$1077 was made per specialist consultation when accessing a local rather than a metropolitan service. Savings were observed in travel time, distance travelled, lost income, provision of an escort and waiting time. Conclusion: The present study shows that the personal costs and difficulties incurred by rural and remote residents when accessing specialist treatment can be reduced if a visiting specialist service is available. [source]

Pregnancy and neonatal characteristics of opioid-dependent Indigenous Australians: A rural and metropolitan comparison

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2009
Emma TETSTALL
Aims: To identify maternal, obstetric and neonatal characteristics of opioid-dependent Indigenous Australians in rural and metropolitan settings. Methods: Retrospective cohort study of 232 metropolitan and 67 rural infants born to mothers maintained on methadone throughout pregnancy for the treatment of opiate dependency, between January 2000 and December 2006. Medical records of identified mother/infant dyads were reviewed by evaluating 20 different maternal, obstetric and neonatal parameters. Results: The number of infants of opiate-dependent mothers (IODMs) identified to be of Aboriginal ethnicity was 47 in the rural and 50 in the metropolitan setting. This reflected a significantly higher proportion in the rural versus metropolitan areas (70.1% vs 21.6%, P < 0.05). The effect of rurality was independent of ethnicity with significantly lower rates of neonatal withdrawal requiring treatment (P < 0.001), antenatal consultations (P < 0.01), department of community services (DoCS) involvement (P < 0.001) and shorter infant lengths of stay (P < 0.001). There was a non-significant trend towards more intrauterine growth restriction in Aboriginal infants. There were no significant differences in parameters in rural Indigenous versus rural non-Indigenous infants. Conclusions: Significant differences exist between rural and metropolitan IODMs in terms of less attendance at antenatal consultations, less neonatal withdrawal requiring treatment, shorter average length of hospital stay for the infant and less documented DoCS involvement. These differences maybe a reflection of a different diagnostic and management approach. Ethnicity had no major clinical impact in either the rural or the metropolitan settings. Future research comparing the long-term outcomes would be of interest. [source]