Health care for older people in rural and remote Australia: challenges for service provision

Gardiner, Fergus William; Bishop, Lara; Harwood, Abby; Gardiner, Elli; Gale, Lauren; Teoh, Narcissus; Lucas, Robyn; Laverty, Martin

doi:10.5694/mja2.50277

Cited by 23 publications

(30 citation statements)

References 3 publications

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“…Many GI conditions require specialist assistance for diagnosis and management. Within rural and remote Australia, the rates of specialist doctor provision (including gastroenterologists) is 27 per 100 000 population, well below suggested benchmarks of 100 per 100 000 population …”

Section: Patient Primary Diagnosis By Gastrointestinal Disease 2014–mentioning

confidence: 77%

“…Prevention of acute GI disease and acute worsening of chronic GI conditions is preferable to emergency presentation. Many of the areas serviced by the RFDS do not have regular access to general practitioner or nursing support, with no gastroenterology specialist nurse support . Many of the GI conditions resulting in the need for RFDS aeromedical transfer are chronic conditions that intermittently worsen and then improve with the appropriate care.…”

Section: Discussionmentioning

confidence: 99%

“…While there have been rural and remote studies on specific conditions, such as colorectal cancer, there is no literature associated with the breadth of GI diagnoses responsible for the transfer of rural and remote patients to inner‐regional and major city hospitals. It is likely that the scarcity of specialist gastroenterologists in rural and remote areas contributes to aeromedical retrieval of patients with GI disease to metropolitan areas. By reporting on the rates of aeromedical retrievals for GI disease, we hope to better understand the unmet needs for rural‐based GI specialist support.…”

Section: Patient Primary Diagnosis By Gastrointestinal Disease 2014–mentioning

confidence: 99%

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Aeromedical retrievals for gastrointestinal disorders in rural and remote Australia: the need for improved access to specialist advice

Gardiner

Bishop

McMahon

et al. 2020

Internal Medicine Journal

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et al. Effect of tacrolimus and cyclosporine A on suppression of albumin secretion induced by inflammatory cytokines in cultured human hepatocytes. Inflamm Res 2006; 55: 216-20. 18 Ramachandran R, Hn HK, Kumar V, Nada R, Yadav AK, Goyal A et al. Tacrolimus combined with corticosteroids versus modified Ponticelli regimen in treatment of idiopathic membranous nephropathy: randomized control trial. Nephrology (Carlton) 2016; 21: 139-46. AbstractThe Royal Flying Doctor Service (RFDS) provides medical care to populations without access to traditional health-care services. From 2014 to 2018 the RFDS conducted 6007 (≈1201/year) aeromedical retrievals for gastrointestinal (GI) disorders. More detailed research is needed to determine specific GI disorders that contributed to this caseload, and in particular inform whether the establishment of a GI specialist service is justified.There is little research on the rates of gastrointestinal (GI) disorders in rural and remote Australia. While there have been rural and remote studies on specific conditions, such as colorectal cancer, 1 there is no literature

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Section: Patient Primary Diagnosis By Gastrointestinal Disease 2014–mentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Patient Primary Diagnosis By Gastrointestinal Disease 2014–mentioning

confidence: 99%

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Aeromedical retrievals for gastrointestinal disorders in rural and remote Australia: the need for improved access to specialist advice

Gardiner

Bishop

McMahon

et al. 2020

Internal Medicine Journal

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“…Similar to countries of vast expanse such as North America and China, Australian populations living in rural and remote regions typically have poorer health compared to those living in major cities . Rural and remote Australians have a higher prevalence of disease risk factors, such as smoking, overweight and obesity, and alcohol and drug misuse compared to major cities .…”

Section: Introductionmentioning

confidence: 99%

“…Rural and remote Australians have a higher prevalence of disease risk factors, such as smoking, overweight and obesity, and alcohol and drug misuse compared to major cities . Furthermore, there is reduced access to health care and long distances to travel to receive medical services . These factors, in combination, result in higher rates of chronic diseases, increased morbidity and mortality for people living in rural and remote regions compared to those living in major cities…”

Section: Introductionmentioning

confidence: 99%

Poor access to kidney disease management services in susceptible patient populations in rural Australia is associated with increased aeromedical retrievals for acute renal care

Gardiner

Bishop²,

Gale³

et al. 2020

Internal Medicine Journal

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Background Inequalities in access to renal services and acute care for rural and remote populations in Australia have been described but not quantified. Aim To describe: the coverage of renal disease management services in rural and remote Australia; and the characteristics of patients who had an aeromedical retrieval for renal disease by Australia's Royal Flying Doctor Service (RFDS). Methods Data from the RFDS, the Australian Bureau of Statistics, and Health Direct were used to estimate provision of renal disease management services by geographic area. RFDS patient diagnostic data were prospectively collected from 2014 to 2018. Results Many rural and remote areas have limited access to regular renal disease management services. Most RFDS retrievals for renal disease are from regions without such services. The RFDS conducted 1636 aeromedical retrievals for renal disease, which represented 1.6% of all retrievals. Among retrieved patients, there was a higher proportion of men than women (54.6% vs 45.4%, P < 0.01), while indigenous patients (n = 546, 33.4%) were significantly younger than non‐indigenous patients (40.9 vs 58.5, P < 0.01). There were significant differences in underlying diagnoses triggering retrievals between genders, with males being more likely than females to be transferred with acute renal failure, calculus of the kidney and ureter, renal colic, obstructive uropathy, and kidney failure (all P < 0.01). Conversely, females were more likely to have chronic kidney disease, disorders of the urinary system, acute nephritic syndrome, tubulo‐interstitial nephritis, and nephrotic syndrome (all P < 0.01). Conclusion Aeromedical retrievals for acute care were from rural areas without regular access to renal disease prevention or management services.

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A Cohort Comparison Study on Women in Threatened Preterm Labor Given Nifedipine or Nifedipine and Salbutamol Tocolysis in Air Medical Retrieval

Spring

Gardiner

Bloxsome

et al. 2022

Air Medical Journal

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Health care for older people in rural and remote Australia: challenges for service provision

Cited by 23 publications

References 3 publications

Aeromedical retrievals for gastrointestinal disorders in rural and remote Australia: the need for improved access to specialist advice

Aeromedical retrievals for gastrointestinal disorders in rural and remote Australia: the need for improved access to specialist advice

Poor access to kidney disease management services in susceptible patient populations in rural Australia is associated with increased aeromedical retrievals for acute renal care

A Cohort Comparison Study on Women in Threatened Preterm Labor Given Nifedipine or Nifedipine and Salbutamol Tocolysis in Air Medical Retrieval

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