Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply

McGrail, Matthew Richard; Wingrove, Peter; Petterson, Stephen; Humphreys, John Stirling; Russell, Deborah; Bazemore, Andrew

doi:10.22605/rrh3925

Cited by 20 publications

(36 citation statements)

References 29 publications

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“…Similar to findings reported regarding primary care physicians, 37 counties with higher levels of education and higher incomes commonly had greater access to child psychiatrists. For example, a county in the 95th percentile of college graduates would be expected to have 9.8 times as many child psychiatrists as a county in the fifth percentile.…”

Section: Distribution By Sociodemographic Characteristicssupporting

confidence: 78%

Growth and Distribution of Child Psychiatrists in the United States: 2007–2016

et al. 2019

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BACKGROUND: Historically, there has been a shortage of child psychiatrists in the United States, undermining access to care. This study updated trends in the growth and distribution of child psychiatrists over the past decade. METHODS: Data from the Area Health Resource Files were used to compare the number of child psychiatrists per 100 000 children ages 0 to 19 between 2007 and 2016 by state and county. We also examined sociodemographic characteristics associated with the density of child psychiatrists at the county level over this period using negative binomial multivariable models. RESULTS: From 2007 to 2016, the number of child psychiatrists in the United States increased from 6590 to 7991, a 21.3% gain. The number of child psychiatrists per 100 000 children also grew from 8.01 to 9.75, connoting a 21.7% increase. County-and state-level growth varied widely, with 6 states observing a decline in the ratio of child psychiatrists (ID, IN, KS, ND, SC, and SD) and 6 states increasing by .50% (AK, AR, NH, NV, OK, and RI). Seventy percent of counties had no child psychiatrists in both 2007 and 2016. Child psychiatrists were significantly more likely to practice in high-income counties (P , .001), counties with higher levels of postsecondary education (P , .001), and metropolitan counties compared with those adjacent to metropolitan regions (P , .05). CONCLUSIONS: Despite the increased ratio of child psychiatrists per 100 000 children in the United States over the past decade, there remains a dearth of child psychiatrists, particularly in parts of the United States with lower levels of income and education.

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Section: Distribution By Sociodemographic Characteristicssupporting

confidence: 78%

Growth and Distribution of Child Psychiatrists in the United States: 2007–2016

et al. 2019

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“…Social capital is clearly focused in Northern regions of Western Australia, with one node – Broome - being its mainstay, as demonstrated by Social Network Analysis measures, particularly with respect to its substantial “betweenness” score which is indicative of its centrality [24]. This was a potentially unexpected result, because Broome is both smaller and more remote than larger and more accessible regional towns that could be expected to be attractive for new graduates [20].…”

Section: Discussionmentioning

confidence: 99%

“…To date no such analysis has been carried out. However, these data are important in further understanding the RCS phenomenon - which is a prototype of educational interventions intended to have workforce effect - with respect to workforce distribution to even the most remote parts of a country, through identifying the extent to which social networks may be involved in workforce development, as opposed to more conventionally examined factors such as financial benefits, and geographical attractiveness [20].…”

Section: Introductionmentioning

confidence: 99%

Social network analysis of rural medical networks after medical school immersion in a rural clinical school

Playford

Burkitt

Atkinson

2019

BMC Health Serv Res

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Background The impact of new medical graduates on the social dimensions of the rural medical workforce is yet to be examined. Social Network Analysis (SNA) is able to visualize and measure these dimensions. We apply this method to examine the workforce characteristics of graduates from a representative Australian Rural Clinical School. Methods Participants were medical graduates of the Rural Clinical School of Western Australia (RCSWA) from the 2001–2014 cohorts, identified as being in rural work in 2017 by the Australian Health Practitioner Regulation Agency. SNA was used to examine the relationships between site of origin and of work destination. Data were entered into UCInet 6 as tied pairs, and visualized using Netdraw. UCINet statistics relating to node centrality were obtained from the node editor. Results SNA measures showed that the 124 of 709 graduates in rural practice were distributed around Australia, and that their practice was strongly focused on the North, with a clear centre in the remote Western Australian town of Broome. Women were strongly recruited, and were widely distributed. Conclusions RCSWA appears to be a “weak tie” according to SNA theory: the School attracts graduates to rural nodes where they had only passing prior contact. The multiple activities that comprise the social capital of the most attractive, remote, node demonstrate the clear workforce effects of being a “bridge, broker and boundary spanner” in SNA terms, and add new understanding about recruiting to the rural workforce.

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“…1 Since the mid-1990s, the federal government has introduced initiatives to address rural health workforce shortages, including targets for inclusion of rural-background medical students, longer rural clinical placements and rural clinical schools. 6 Widening participation (WP) and widening access (WA) are two different strategies that aim to increase the diversity of medical students entering medical school, premised to increase culturally and socially appropriate health care to help overcome disparity. [3][4][5] Despite progress in regional and 'more attractive' rural communities, medical workforce remains heavily metropolitan-based.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Despite progress in regional and 'more attractive' rural communities, medical workforce remains heavily metropolitan-based. 6 Widening participation (WP) and widening access (WA) are two different strategies that aim to increase the diversity of medical students entering medical school, premised to increase culturally and socially appropriate health care to help overcome disparity. 3,7,8 WP refers to proportional inclusion of students representing the broader community, including those from disadvantaged backgrounds, mature age students, ethnic and cultural groups and students with a disability.…”

Section: Introductionmentioning

confidence: 99%

Building a medical workforce in Tasmania: A profile of medical student intake

Cheek

Hays

Allen

et al. 2019

Australian J Rural Health

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Objective: To identify under-represented groups in a medical school intake. Design: Descriptive analysis of student demographic characteristics. Setting: One state-wide medical school. Participants: All students enrolled between 2010 and 2016. Main outcome measure(s): Proportion of students from regional and rural areas, state versus independent schools, highest parental qualification, Aboriginal or Torres Strait Islander students. Results: Of 819 students, 472 (57.6%) were from Tasmania, five (1.1%) identified as Aboriginal or Torres Strait Islanders, 335 (71.0%) completed their secondary education at independent schools and 137 (29.0%) at government schools. The overall median Modified Monash Model was 2 (range 1-6) and median Australia Statistical Geography Standard Remoteness Area was 2 (inner regional: range 1-4), reflecting that a majority came from one of the two main cities. Over two-thirds (69.5%) had a parent with a Bachelor degree or higher qualification, regardless of the school attended. Just under half (225, 47.7%) of all Tasmanian students attended a secondary school with a parental contribution of ≥$5000 per annum. These students attended a small number of independent schools, with the proportion relatively stable over the period from 2010 to 2016. Conclusion: Widening participation and widening access initiatives to graduate doctors who understand and want to work in communities in need might not be working as well in Tasmania as elsewhere in Australia. Social accountability might be improved by adapting a rural classification that reflects the demographic profile of Tasmania.

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Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply

Cited by 20 publications

References 29 publications

Growth and Distribution of Child Psychiatrists in the United States: 2007–2016

Growth and Distribution of Child Psychiatrists in the United States: 2007–2016

Social network analysis of rural medical networks after medical school immersion in a rural clinical school

Building a medical workforce in Tasmania: A profile of medical student intake

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