Access and outcomes of general practitioner obstetrician (rural generalist)‐supported birthing units in Queensland

Abstract

Objective To describe characteristics and outcomes of women birthing within GP‐obstetrician (rural generalist) supported rural (level 3) obstetric units in Queensland. Design Retrospective descriptive study. Setting 21 GP‐obstetrician supported birthing units in Queensland. Participants Women (n = 3111) birthing from January 2017 to December 2017. Main outcome measures Patient, pregnancy and labour characteristics and key maternal and neonatal outcomes routinely recorded in the Queensland Perinatal Data Collection and Queensland Hospital Admitted Patient Data Collection were compared to Queensland public hospital aggregate data. Results Women birthing in rural maternity units were significantly more likely to be Aboriginal or Torrs Strait Islander (16% v 9%), < 20 years old (7% v 4%), term deliveries (96% v 91%), achieve spontaneous onset of labour (67% v 51%), and birth (71% v 60%) (p<0.001) compared with all Queensland public hospitals. They were significantly less likely to be nulliparous (36% v 40%), use pharmacological analgesia (65% v 69%), or have continuous electronic fetal monitoring in labour (54% v 66%) (p<0.001). Neonatal outcomes were comparable; with no significant difference in stillbirth rate between rural units and all Queensland public hospitals (4.8 v 7.3 per 1000 births). Precipitate delivery was the most common labour complication (36% v 33%) (p<0.001). Conclusion GP‐obstetrician (rural generalist) supported rural birthing units in Queensland provide important access for low and medium risk women to deliver locally, with strong indicators of quality and safety.

Surveying the changing climate of Northern Territory medical workforce retention

“…However, outside of general practice, significant gaps remain in specialist training pipelines outside of metropolitan areas 21 . In Queensland, the establishment of rural generalist training has been successful in improving access to services traditionally delivered by non‐GP specialists 22 . The broader expansion of the rural generalist model could achieve similar outcomes in other jurisdictions 23 ; however, coordination is needed to ensure structural, policy and industrial conditions support rural generalist models of training and service delivery 21 .…”

“…21 In Queensland, the establishment of rural generalist training has been successful in improving access to services traditionally delivered by non-GP specialists. 22 The broader expansion of the rural generalist model could achieve similar outcomes in other jurisdictions 23 ; however, coordination is needed to ensure structural, policy and industrial conditions support rural generalist models of training and service delivery. 21 Strengthening collaboration between training organisations in rural and remote areas could increase capacity and reduce the gaps in vocational training pathways.…”

General practitioner obstetricians’ models of care in rural Western Australia

“…A recent Queensland-based study demonstrated that GPO-supported birthing units had strong indicators of quality and safety. 5 The National Rural Generalist Taskforce recognise the importance of supporting and valuing of rural generalists, including…”

“…There has been little academic attention paid to the role of GPs or GPOs on outcomes in maternity care. A recent Queensland‐based study demonstrated that GPO‐supported birthing units had strong indicators of quality and safety 5 …”

“…A recent Queensland‐based study demonstrated that GPO‐supported birthing units had strong indicators of quality and safety. 5 …”