Improving Access to Safe Anesthetic Care in Rural and Remote Communities in Affluent Countries

Abstract

Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. This report summarizes the challenges facing the provision of anesthesia services in rural and remote regions. The current landscape of anesthesia providers and their training is described. We also explore innovative strategies and emerging technologies that could better support physician-led anesthesia care teams working in rural and remote areas. Ultimately, we believe that it is the responsibility of specialist anesthesiologists and academic health sciences centers to facilitate access to high-quality care through partnership with other stakeholders. Professional medical organizations also play an important role in ensuring the quality of care and continuing professional development. Enhanced collaboration between academic anesthesiologists and other stakeholders is required to meet the challenge issued by the World Health Organization to ensure access to essential anesthesia and surgical services for all.

Qualities of Effective Vital Anaesthesia Simulation Training Facilitators Delivering Simulation-Based Education in Resource-Limited Settings

“…Though resource-limited environments are often thought of as existing exclusively in LMICs, there are many resource-limited environments in HICs that present challenges similar to their LMIC counterparts. 36 In resource-limited environments, low-cost simulation is emerging as a useful educational method. 5 VAST has demonstrated the capacity to produce sustained improvements in course participants' nontechnical skills.…”

The anesthesia workforce in Canada: a methodology to identify physician anesthesia providers using health administrative data

“…In some Canadian regions, access to timely anesthesia care has been limited [ 7 ]. Multiple issues are at play, including increasing demand for anesthesia services both inside and outside operating rooms [ 8 , 9 ], constrained availability of anesthesia care providers and other resources[ 10 ] (e.g., a lack of anesthesia assistants), geographic and workforce distribution challenges [ 12 ], and an aging workforce.…”

Who Provides Anesthesia Services in Canada? A Methodology to Identify the Physician Anesthesia Workforce Using Health Administrative Data

“…Timely access to care is of particular concern for Indigenous and non-Indigenous peoples living in rural and remote regions of the country. 1,2,3,4 Despite the importance of evidence-informed approaches to workforce decision-making, pan-Canadian data that capture the need for anesthesia care, the number of anesthesia providers and the volume of clinical service they provide, and the gap between population demand and workforce capacity, are conspicuously absent.…”