Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Shah, Tayyab; Clark, Andrew; Seabrook, Jamie A.; Sibbald, Shannon L.; Gilliland, Jason A.

doi:10.1111/cag.12557

Cited by 46 publications

(49 citation statements)

References 42 publications

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“…Access to PHC services is a considerable health delivery concern across Canada with important health policy implications. Some communities, particularly in rural and remote areas, do not have the same access to a range of primary health care professionals [5,6]. Such differences in access to health services have negative consequences for best meeting population health needs.…”

Section: Introductionmentioning

confidence: 99%

Geographic availability to optometry services across Canada: mapping distribution, need and self-reported use

Shah

Milosavljevic

Bath

2020

BMC Health Serv Res

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Background: This research investigates the distribution of optometrists in Canada relative to population health needs and self-reported use of vision services. Methods: Optometrist locations were gathered from provincial regulatory bodies. Optometrist-to-population ratios (i.e. the number of providers per 10,000 people at the health region level) were then calculated. Utilization of vision care services was extracted from the Canadian Community Health Survey (CCHS) 2013-2014 question regarding self-reported contacts with optometrists or ophthalmologists. Data from the 2016 Statistics Canada census were used to create three population 'need' subgroups (65 years and over; low-income; and people aged 15 and over with less than a high school diploma). Cross-classification mapping compared optometrist distribution to selfreported use of vision care services in relation to need. Each variable was converted into three classes (i.e., low, moderate, and high) using a standard deviation (SD) classification scheme where ±0.5SD from the mean was considered as a cutoff. Three classes: low (< − 0.5SD), moderate (− 0.5 to 0.5SD), and high (> 0.5SD) were used for demonstrating distribution of each variable across health regions. Results: A total of 5959 optometrists across ten Canadian provinces were included in this analysis. The nationwide distribution of optometrists is variable across Canada; they are predominantly concentrated in urban areas. The national mean ratio of optometrists was 1.70 optometrists per 10,000 people (range = 0.13 to 2.92). Out of 109 health regions (HRs), 26 were classified as low ratios, 51 HRs were classified as moderate ratios, and 32 HRs were high ratios. Thirty-five HRs were classified as low utilization, 39 HRs were classified as moderate, and 32 HRs as high utilization. HRs with a low optometrist ratio relative to eye care utilization and a high proportion of key sociodemographic characteristics (e.g. older age, low income) are located throughout Canada and identified with maps indicating areas of likely greater need for optometry services. Conclusion: This research provides a nationwide overview of vision care provided by optometrists identifying gaps in geographic availability relative to "supply" and "need" factors. This examination of variation in accessibility to optometric services will be useful to inform workforce planning and policies.

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Section: Introductionmentioning

confidence: 99%

Geographic availability to optometry services across Canada: mapping distribution, need and self-reported use

Shah

Milosavljevic

Bath

2020

BMC Health Serv Res

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“…However, many rural and remote communities worldwide often experience high levels of inaccessibility of healthcare (Thomas, Wakerman, and Humphreys 2015). Even within the developed world (World Health Organisation (WHO) 2015), equitable and accessible healthcare is di cult to achieve, particularly in rural populations where accessibility to quality healthcare can be determined by the socioeconomic status of families (Shah et al 2020). In Zimbabwe, 67.8% of the population live in rural areas (Zimbabwe National Statistics Agency 2018) and approximately 9 million Zimbabweans (63%) lack access to healthcare.…”

Section: Introductionmentioning

confidence: 99%

A Strategic Action Plan to Enhance the Accessibility of Healthcare in Rural Areas of Zimbabwe

Mangundu

Roets

Rensburg

2020

Preprint

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Background: Accessibility to health care in rural areas of Zimbabwe is challenging. Developing a strategic action plan was in essence, a road map leading to a required potential like achieving a goal. Wider consultation with communities, healthcare leaders and policymakers to inform development of strategic action plan, often overlooked has necessitated this research. The aim was to identify strategies and develop a strategic action plan to enhance accessibility to healthcare in rural areas of Zimbabwe through active involvement of key stakeholders like healthcare users, healthcare workers, leaders and legislators.Methods: A multiple methods approach were used and study was carried out in 4 phases. In Phase 1 (quantitative), data was collected from professional nurses using self-administered questionnaire and health care users using interview questionnaire. Phase 2 (qualitative) collected data through a nominal group with national health directors. A strategic action plan was developed in phase 3 using findings from phase 1 and 2, the Systems Model and a literature control. In phase 4, the strategic action plan was finalised and validated by members of parliamentary portfolio committee on health who were members of parliament of Zimbabwe. Two districts (Masvingo and Chegutu) in two provinces (Masvingo and Mashonaland West) were included in the study, targeting 45 public health facilities in rural areas of Zimbabwe.Participants included in the study were conveniently sampled professional nurses (90), health care users (445) using the sampled public health facilities (phase 1), conveniently sampled 5 national health coordinators (phase 2) and all-inclusive 5 members of the parliamentary portfolio committee on health (phase 4).Results: The study contributed to the development and validation of the strategic action plan with 6 strategies. These included improving the health infrastructure, provision of medical drugs, health workers, medical equipment, reviewing the health worker workload and addressing shortages, and improving the capacity of the health care system.Conclusion: The active participation at all phases by professional nurses, health care users, national health directors and members of parliament contributed to development of a strategic action plan with 6 strategies to enhance accessibility to health care in rural areas of Zimbabwe.

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“…3 Yet, there are significant differences in access and outcomes between rural and urban populations. [4][5][6] People living in rural communities have higher rates of morbidity and mortality related to chronic disease and injuries compared with urban populations. 5 6 Although Canada is an increasingly urbanised country, 28.3% of the population lives outside of a metropolitan area, and 6 million Canadians live in rural and remote areas.…”

Section: Introductionmentioning

confidence: 99%

Rural family physician perspectives on communication with urban specialists: a qualitative study

et al. 2021

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ObjectiveCommunication is a key competency for medical education and comprehensive patient care. In rural environments, communication between rural family physicians and urban specialists is an essential pathway for clinical decision making. The aim of this study was to explore rural physicians’ perspectives on communication with urban specialists during consultations and referrals.SettingNewfoundland and Labrador, Canada.ParticipantsThis qualitative study involved semistructured, one-on-one interviews with rural family physicians (n=11) with varied career stages, geographical regions, and community sizes.ResultsFour themes specific to communication in rural practice were identified. The themes included: (1) understanding the contexts of rural care; (2) geographical isolation and patient transfer; and (3) respectful discourse; and (4) overcoming communication challenges in referrals and consultations.ConclusionsCommunication between rural family physicians and urban specialists is a critical task in providing care for rural patients. Rural physicians see value in conveying unique aspects of rural clinical practice during communication with urban specialists, including context and the complexities of patient transfers.

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Geographic accessibility to primary care providers: Comparing rural and urban areas in Southwestern Ontario

Cited by 46 publications

References 42 publications

Geographic availability to optometry services across Canada: mapping distribution, need and self-reported use

Geographic availability to optometry services across Canada: mapping distribution, need and self-reported use

A Strategic Action Plan to Enhance the Accessibility of Healthcare in Rural Areas of Zimbabwe

Rural family physician perspectives on communication with urban specialists: a qualitative study

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