To exponentially amplify the impact of health research in regional, rural, remote, and very remote (RRRvR) communities for improved health outcomes and reduced health inequities.
Context
RRRvR health inequities are severe, enduring, and largely impervious to our best efforts to address them. It is unjust that, simply because of where they live, some people do not have the health they need to live the life they want. Although research has been one of our greatest inventions for solving problems, it has had little impact on the problems with which RRRvR communities grapple. Improving the beneficial impact of RRRvR research was the focus of a recent Research Australia University Roundtable.
Approach
As someone with an abiding interest in research methodologies and the research process more generally, I read widely on research matters, am research active, review research funding applications, and train others in research processes. This commentary is a synthesis of my insights from the Roundtable as well as the published literature, including my own published work.
Conclusion
For people in RRRvR communities to reap the benefits that research has the potential to offer, far more substantive changes are required than adjusting assessment criteria or funding streams. It is the context within which research is conceived and conducted that must be reimagined. Without changing the context, other alterations are likely to be ineffective. When research becomes a genuine partnership between researchers and RRRvR communities to answer locally prioritised problems, we might finally achieve the impact that is required.
{"title":"How Can Research Have Greater Beneficial Impact in Rural Australia?","authors":"Timothy A. Carey","doi":"10.1111/ajr.70104","DOIUrl":"10.1111/ajr.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To exponentially amplify the impact of health research in regional, rural, remote, and very remote (RRRvR) communities for improved health outcomes and reduced health inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>RRRvR health inequities are severe, enduring, and largely impervious to our best efforts to address them. It is unjust that, simply because of where they live, some people do not have the health they need to live the life they want. Although research has been one of our greatest inventions for solving problems, it has had little impact on the problems with which RRRvR communities grapple. Improving the beneficial impact of RRRvR research was the focus of a recent Research Australia University Roundtable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>As someone with an abiding interest in research methodologies and the research process more generally, I read widely on research matters, am research active, review research funding applications, and train others in research processes. This commentary is a synthesis of my insights from the Roundtable as well as the published literature, including my own published work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For people in RRRvR communities to reap the benefits that research has the potential to offer, far more substantive changes are required than adjusting assessment criteria or funding streams. It is the context within which research is conceived and conducted that must be reimagined. Without changing the context, other alterations are likely to be ineffective. When research becomes a genuine partnership between researchers and RRRvR communities to answer locally prioritised problems, we might finally achieve the impact that is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>I learned it was ‘Women's Health Week’ in Australia the first week of September, almost a week after the occasion. It came and went without the recognition it deserved. Women are just over half of the Australian population, including across regional to very remote areas of Australia [<span>1</span>], yet Women's Health remains a problem drawing patchy attention.</p><p>Women (and girls) from regional to very remote (or rural) areas are internationally recognised as a priority population, and women in rural areas play a crucial role in strengthening their communities [<span>2, 3</span>]. Women are the stalwart backbone of their communities, often also holding responsibility and care for everyone around them. I was asked to write about ‘Women and Rural Health’, but the topic is enormous. Where do we set our focus?</p><p>Women's rights and women's health rights are once again being challenged, diminished and removed in nations around the world. In Australia, there are numerous policies, strategies and initiatives in place to address gaps in healthcare for women and for those living in rural communities, from the federal government to the local health systems and even the non-government agencies within the states and territories. The Australian Government's Minister for Women has identified Health as one of five priority areas. Priority area 4 of the Strategy for Gender Equality states that, ‘Over many decades in Australia and around the world, women's control over their health has been challenged. … A lack of support for women's health not only affects their everyday wellbeing, it also impacts how they participate and thrive at work. …and (women) in regional, remote and rural communities also face additional barriers due to religious or cultural values and beliefs, language and communication challenges or a lack of access [<span>4</span>].’</p><p>The federal Minister for Health has produced a Women's Health Strategy that recognises ‘that women's experiences of mental and physical illness are different from men's [and this] is essential for developing services that are effective in addressing the health needs of women and girls in Australia’ [<span>5</span>]. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has also responded with a strategy to address the ‘barriers that create a financial, logistical and emotional burden on women and their families’ and it will continue to ‘advocate for, and support initiatives that help support the equitable delivery of services’ [<span>6</span>].</p><p>The rules of play are being laid out, but there remains a clear gap in access to healthcare and a shortage of appropriate health providers to meet the unique health needs of women, especially in rural Australia.</p><p>In Australia, women significantly outnumber men in the health workforce—no matter the discipline, classification, or location (78% Australia-wide, 80% in rural areas) [<span>7</span>]. Women also outnumber men in the t
{"title":"I Am (Rural) Woman","authors":"Emily Saurman","doi":"10.1111/ajr.70103","DOIUrl":"10.1111/ajr.70103","url":null,"abstract":"<p>I learned it was ‘Women's Health Week’ in Australia the first week of September, almost a week after the occasion. It came and went without the recognition it deserved. Women are just over half of the Australian population, including across regional to very remote areas of Australia [<span>1</span>], yet Women's Health remains a problem drawing patchy attention.</p><p>Women (and girls) from regional to very remote (or rural) areas are internationally recognised as a priority population, and women in rural areas play a crucial role in strengthening their communities [<span>2, 3</span>]. Women are the stalwart backbone of their communities, often also holding responsibility and care for everyone around them. I was asked to write about ‘Women and Rural Health’, but the topic is enormous. Where do we set our focus?</p><p>Women's rights and women's health rights are once again being challenged, diminished and removed in nations around the world. In Australia, there are numerous policies, strategies and initiatives in place to address gaps in healthcare for women and for those living in rural communities, from the federal government to the local health systems and even the non-government agencies within the states and territories. The Australian Government's Minister for Women has identified Health as one of five priority areas. Priority area 4 of the Strategy for Gender Equality states that, ‘Over many decades in Australia and around the world, women's control over their health has been challenged. … A lack of support for women's health not only affects their everyday wellbeing, it also impacts how they participate and thrive at work. …and (women) in regional, remote and rural communities also face additional barriers due to religious or cultural values and beliefs, language and communication challenges or a lack of access [<span>4</span>].’</p><p>The federal Minister for Health has produced a Women's Health Strategy that recognises ‘that women's experiences of mental and physical illness are different from men's [and this] is essential for developing services that are effective in addressing the health needs of women and girls in Australia’ [<span>5</span>]. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has also responded with a strategy to address the ‘barriers that create a financial, logistical and emotional burden on women and their families’ and it will continue to ‘advocate for, and support initiatives that help support the equitable delivery of services’ [<span>6</span>].</p><p>The rules of play are being laid out, but there remains a clear gap in access to healthcare and a shortage of appropriate health providers to meet the unique health needs of women, especially in rural Australia.</p><p>In Australia, women significantly outnumber men in the health workforce—no matter the discipline, classification, or location (78% Australia-wide, 80% in rural areas) [<span>7</span>]. Women also outnumber men in the t","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Australia prides itself on the principle of a universal health system. But that promise rings hollow when access to essential services and health outcomes are largely determined by your postcode.</p><p>The National Rural Health Alliance (NRHA) engaged the Nous Group to deliver an updated, more comprehensive analysis of rural health investment in Australia. The overall findings confirmed what regional, rural and remote (hereafter rural) Australians have long known: the health funding gap between the city and country continues to grow, placing lives, communities and the economy at risk.</p><p>In 2023–24, the health spend shortfall for people living in rural communities, compared to metropolitan areas, reached a staggering <b>$8.35 billion</b> or <b>$1090.47 per person per year</b>. Even when using like-for-like comparison with the scope of the initial 2023 report, and adjusting for inflation, the per capita gap has still <b>grown by $110</b>. This widening chasm reveals not only deep inequity in healthcare access but systemic underinvestment in the very people who drive our national economy.</p><p>This new report provides a more comprehensive picture than ever before. It includes public and private spending across the full spectrum of healthcare services: hospitals, the Medicare Benefits Scheme (MBS), Pharmaceutical Benefits Scheme (PBS), Department of Veteran Affairs (DVA), National Disability Insurance Scheme (NDIS), aged care, private allied health, dentistry, Primary Health Networks (PHNs), Aboriginal and Torres Strait Islander primary healthcare, Royal Flying Doctor Service (RFDS), ambulance services and Commonwealth workforce programmes. The health expenditure data has also been broken down by Modified Monash Model (MMM) and, where available, by state and territory, revealing a more accurate and granular representation to date of healthcare investment (and underinvestment) in rural Australia.</p><p>The shortfall is driven largely by lower investment in public hospitals, private hospitals, MBS services, private allied healthcare and dentistry in rural and remote regions. In <i>Very Remote</i> communities, targeted programmes, such as RFDS and Aboriginal and Torres Strait Islander primary healthcare are helping fill the gaps, but this highlights just how much mainstream systems are failing rural populations and require supplementation from special-purpose programmes.</p><p>Simply put, rural Australians need more care yet receive less per capita than urban populations.</p><p>There's currently no national definition of what constitutes ‘reasonable access to care’ across different regions of Australia, a glaring gap in health policy. Stakeholders agree that this lack of definition, along with disjointed policy responsibilities across federal, state and private systems, including inflexible funding models and policies, is contributing to persistent and growing inequity. Without a shared standard for access, the system defaults to urban-centric s
{"title":"The Forgotten Health Spend: Time to Prioritise Rural Health Equity","authors":"Leanne Kelly","doi":"10.1111/ajr.70102","DOIUrl":"https://doi.org/10.1111/ajr.70102","url":null,"abstract":"<p>Australia prides itself on the principle of a universal health system. But that promise rings hollow when access to essential services and health outcomes are largely determined by your postcode.</p><p>The National Rural Health Alliance (NRHA) engaged the Nous Group to deliver an updated, more comprehensive analysis of rural health investment in Australia. The overall findings confirmed what regional, rural and remote (hereafter rural) Australians have long known: the health funding gap between the city and country continues to grow, placing lives, communities and the economy at risk.</p><p>In 2023–24, the health spend shortfall for people living in rural communities, compared to metropolitan areas, reached a staggering <b>$8.35 billion</b> or <b>$1090.47 per person per year</b>. Even when using like-for-like comparison with the scope of the initial 2023 report, and adjusting for inflation, the per capita gap has still <b>grown by $110</b>. This widening chasm reveals not only deep inequity in healthcare access but systemic underinvestment in the very people who drive our national economy.</p><p>This new report provides a more comprehensive picture than ever before. It includes public and private spending across the full spectrum of healthcare services: hospitals, the Medicare Benefits Scheme (MBS), Pharmaceutical Benefits Scheme (PBS), Department of Veteran Affairs (DVA), National Disability Insurance Scheme (NDIS), aged care, private allied health, dentistry, Primary Health Networks (PHNs), Aboriginal and Torres Strait Islander primary healthcare, Royal Flying Doctor Service (RFDS), ambulance services and Commonwealth workforce programmes. The health expenditure data has also been broken down by Modified Monash Model (MMM) and, where available, by state and territory, revealing a more accurate and granular representation to date of healthcare investment (and underinvestment) in rural Australia.</p><p>The shortfall is driven largely by lower investment in public hospitals, private hospitals, MBS services, private allied healthcare and dentistry in rural and remote regions. In <i>Very Remote</i> communities, targeted programmes, such as RFDS and Aboriginal and Torres Strait Islander primary healthcare are helping fill the gaps, but this highlights just how much mainstream systems are failing rural populations and require supplementation from special-purpose programmes.</p><p>Simply put, rural Australians need more care yet receive less per capita than urban populations.</p><p>There's currently no national definition of what constitutes ‘reasonable access to care’ across different regions of Australia, a glaring gap in health policy. Stakeholders agree that this lack of definition, along with disjointed policy responsibilities across federal, state and private systems, including inflexible funding models and policies, is contributing to persistent and growing inequity. Without a shared standard for access, the system defaults to urban-centric s","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen Hayes, Rosalind Bye, Liz Thyer, Simon McDonald, Kristy Coxon
<div> <section> <h3> Objective</h3> <p>Describe Australian occupational therapy (OT) workforce distribution trends by total numbers, demographics, work type, and job roles across remoteness levels.</p> </section> <section> <h3> Design</h3> <p>Exploratory spatial analysis of workforce distribution compared to total populations between 2013 and 2021.</p> </section> <section> <h3> Setting</h3> <p>Australia.</p> </section> <section> <h3> Participants</h3> <p>OTs participating in registration surveys (2013–2021) and Australians from the 2011, 2016, and 2021 National censuses.</p> </section> <section> <h3> Main Outcome Measures</h3> <p>Proportion of occupational therapists, hours worked, First Nations inclusion, leadership roles, and practice areas across Modified Monash Model (MMM) levels of remoteness compared to populations.</p> </section> <section> <h3> Results</h3> <p>Despite a 72% national workforce increase (over 10 000 OTs) over nine-years, metropolitan areas consistently retained a disproportionate share of workforce, hours worked, specialised practice areas, leadership roles, and First Nations identifying therapists. Regional centres showed the highest growth but would require similar growth for 4–15 years to equal metropolitan ratios, while workforce gaps will likely widen for other remoteness levels. Private sector hours increased substantially by 100-h/10 000 population, while public sector hours increased by just 1-h. However, private sector growth did not extend equitably to rural and remote places. Metropolitan, regional, and large rural towns outpaced all other remoteness levels in leadership growth suggesting a centralising tendency. At current rates, representative First Nations proportions will not be achieved. Equity against 2021 numbers requires redistribution of at least 1717 therapists, 278 formalised leadership positions, and increased specialised services to rural and remote places. At least 598 additional First Nations identifying therapists are needed nationally, of which 406 (68%) are needed in regional, rural, and remote places.</p> </section> <section> <h3> Conclusion</h3> <p>Persistent maldistribution of the OT workforce across remoteness levels reflects structural inequities unlikely to resolve through organic growth. Current rural workforce strategies appear insufficient to address geographic and cultural disparities. Targeted investment in rural workforce developm
{"title":"Rural Workforce Drought: Spatial Analysis Reveals Persistent Maldistribution of the Australian Occupational Therapy Workforce From 2013 to 2021","authors":"Karen Hayes, Rosalind Bye, Liz Thyer, Simon McDonald, Kristy Coxon","doi":"10.1111/ajr.70101","DOIUrl":"10.1111/ajr.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Describe Australian occupational therapy (OT) workforce distribution trends by total numbers, demographics, work type, and job roles across remoteness levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Exploratory spatial analysis of workforce distribution compared to total populations between 2013 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>OTs participating in registration surveys (2013–2021) and Australians from the 2011, 2016, and 2021 National censuses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Proportion of occupational therapists, hours worked, First Nations inclusion, leadership roles, and practice areas across Modified Monash Model (MMM) levels of remoteness compared to populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite a 72% national workforce increase (over 10 000 OTs) over nine-years, metropolitan areas consistently retained a disproportionate share of workforce, hours worked, specialised practice areas, leadership roles, and First Nations identifying therapists. Regional centres showed the highest growth but would require similar growth for 4–15 years to equal metropolitan ratios, while workforce gaps will likely widen for other remoteness levels. Private sector hours increased substantially by 100-h/10 000 population, while public sector hours increased by just 1-h. However, private sector growth did not extend equitably to rural and remote places. Metropolitan, regional, and large rural towns outpaced all other remoteness levels in leadership growth suggesting a centralising tendency. At current rates, representative First Nations proportions will not be achieved. Equity against 2021 numbers requires redistribution of at least 1717 therapists, 278 formalised leadership positions, and increased specialised services to rural and remote places. At least 598 additional First Nations identifying therapists are needed nationally, of which 406 (68%) are needed in regional, rural, and remote places.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Persistent maldistribution of the OT workforce across remoteness levels reflects structural inequities unlikely to resolve through organic growth. Current rural workforce strategies appear insufficient to address geographic and cultural disparities. Targeted investment in rural workforce developm","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to explore healthcare experiences of transgender and gender diverse (TGD) individuals, their whānau (family), and primary care clinicians in rural Aotearoa New Zealand. It explored the enablers of gender-affirming care (GAC) and the challenges that remain, using these insights to build a culturally responsive, strengths-based model of care.
Design
Qualitative study using semi-structured interviews, analyzed via reflexive thematic analysis.
Setting
Whanganui, a regional district in Aotearoa New Zealand.
Participants
Participants included 12 TGD individuals, two whānau members, and five clinicians providing GAC within primary care.
Main Outcome Measures
Experiences of accessing and delivering healthcare, with a focus on GAC pathways, mental health support, and culturally appropriate service models.
Results
TGD participants described fragmented systems requiring self-navigation, with delays, gatekeeping, and limited access to affirming mental health services. Clinicians reported gaps in training, a lack of clear pathways, and few referral options. Both groups emphasized the value of peer support, whānau-centered models, and culturally safe approaches. There was shared support for a local, centralized GAC service in Whanganui, building on existing resources and grounded in cross-sector collaboration, clinician education, and local leadership.
Conclusion
This study demonstrates both the challenges and potential of rural TGD healthcare. Findings support a regionally tailored model of GAC involving services and community, sustained through partnership and grounded in cultural safety. In Whanganui, strong foundations already exist to support such a model. With local adaptation, it could guide equitable service development in other rural regions of Aotearoa.
{"title":"Integrating Lived and Clinical Perspectives to Advance Transgender Healthcare in Rural Aotearoa New Zealand","authors":"Katie E. McMenamin, Angie Enoka","doi":"10.1111/ajr.70100","DOIUrl":"10.1111/ajr.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore healthcare experiences of transgender and gender diverse (TGD) individuals, their whānau (family), and primary care clinicians in rural Aotearoa New Zealand. It explored the enablers of gender-affirming care (GAC) and the challenges that remain, using these insights to build a culturally responsive, strengths-based model of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative study using semi-structured interviews, analyzed via reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Whanganui, a regional district in Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Participants included 12 TGD individuals, two whānau members, and five clinicians providing GAC within primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Experiences of accessing and delivering healthcare, with a focus on GAC pathways, mental health support, and culturally appropriate service models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TGD participants described fragmented systems requiring self-navigation, with delays, gatekeeping, and limited access to affirming mental health services. Clinicians reported gaps in training, a lack of clear pathways, and few referral options. Both groups emphasized the value of peer support, whānau-centered models, and culturally safe approaches. There was shared support for a local, centralized GAC service in Whanganui, building on existing resources and grounded in cross-sector collaboration, clinician education, and local leadership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates both the challenges and potential of rural TGD healthcare. Findings support a regionally tailored model of GAC involving services and community, sustained through partnership and grounded in cultural safety. In Whanganui, strong foundations already exist to support such a model. With local adaptation, it could guide equitable service development in other rural regions of Aotearoa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the use of flipped classroom (FC) design for occupational therapy and speech pathology students studying in regional Australia.
Setting
Occupational therapy and speech pathology students in a regional Australian university in Central Queensland.
Participants
33 occupational therapy and speech pathology students provided survey data; 5 students supplied in-depth data from focus groups; three educators completed teaching reflections.
Design
A multiple case study methodology was implemented based on Yin's definition1. Case study one involved occupational therapy students and case study two involved speech pathology students. A sequential exploratory mixed methods design was embedded within each case study. After participation in a unit using FC design, students completed a quantitative survey followed by a focus group for each case. Document analysis of teacher reflections and unit evaluations was also completed.
Results
Quantitative results show that student confidence, knowledge, and satisfaction are strongly supported by the FC approach. Rich qualitative data from the cases yielded four themes: individual attributes of the educator; purposeful and flexible design features; the role of the student as an active learner; facilities and resources for flipped classrooms.
Conclusion
This case study data supports the benefits of FC design for health professions students, has enabled the development of a conceptual framework which could be applied to health professions and beyond to other disciplines, and has also provided the foundations for guidelines to support educators to implement FC methodology.
{"title":"‘I Couldn't Imagine Doing It Any Other Way’—The Use of Flipped Classroom Design for Occupational Therapy and Speech Pathology Students in a Regional Australian University","authors":"Desley Simpson, Clancy Conlon","doi":"10.1111/ajr.70099","DOIUrl":"10.1111/ajr.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the use of flipped classroom (FC) design for occupational therapy and speech pathology students studying in regional Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Occupational therapy and speech pathology students in a regional Australian university in Central Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>33 occupational therapy and speech pathology students provided survey data; 5 students supplied in-depth data from focus groups; three educators completed teaching reflections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A multiple case study methodology was implemented based on Yin's definition<sup>1</sup>. Case study one involved occupational therapy students and case study two involved speech pathology students. A sequential exploratory mixed methods design was embedded within each case study. After participation in a unit using FC design, students completed a quantitative survey followed by a focus group for each case. Document analysis of teacher reflections and unit evaluations was also completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Quantitative results show that student confidence, knowledge, and satisfaction are strongly supported by the FC approach. Rich qualitative data from the cases yielded four themes: individual attributes of the educator; purposeful and flexible design features; the role of the student as an active learner; facilities and resources for flipped classrooms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study data supports the benefits of FC design for health professions students, has enabled the development of a conceptual framework which could be applied to health professions and beyond to other disciplines, and has also provided the foundations for guidelines to support educators to implement FC methodology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Mustafa, Mark Rodrigues, Ross Lawrenson, Jo Scott-Jones, Valentina Papa, Jinru Zhao, Rebekah Crosswell, Tim Kenealy, Rinki Murphy, Rawiri Keenan, Allan Moffitt, Ryan Paul, Lynne Chepulis
Objective
To examine the demographic differences between individuals with Type 2 Diabetes (T2D) enrolled in rural and urban clinics and evaluate the quality of care they receive.
Design
Cross-sectional observational study.
Setting
Primary care data from four large Primary Healthcare Organisations across the Auckland and Waikato regions of New Zealand.
Participants
Patients aged 18–75 years with T2D from February 2021 to August 2022.
Main Outcomes Measures
Associations between rurality and sociodemographic variables, clinical measures, and prescribing rates.
Results
A total of 56 937 patients with T2D were included, with 85.3% enrolled in urban practices and 14.7% in rural. Rural clinics had a significantly higher proportion of Māori individuals than urban clinics (31.4% vs. 17.4%). Patients in rural clinics had lower but not clinically significant reductions in mean HbA1c, LDL-c, blood pressure, and eGFR than those in urban clinics; however, the number of laboratory tests completed during the study period was lower in rural clinics. Māori were less likely to receive HbA1c and uACR tests than non-Māori. Clinically indicated prescribing for metformin (79.1% vs. 72.5%), ACE inhibitors (80.5% vs. 75.2%), and statins (61.2% vs. 54.4%) was higher in patients enrolled in urban than rural clinics (all p < 0.05), and regression showed lower odds of insulin (OR: 0.65, 95% CI: 0.61–0.69) and SGLT2i/GLP1RA (OR: 0.87, 95% CI: 0.82–0.93) prescribing in rural clinics (both p < 0.001).
Conclusion
Targeted strategies are needed to address the disparities in T2D care for patients in rural clinics, as well as Māori, particularly optimizing medication prescribing and laboratory tests to improve overall care.
目的：研究在农村和城市诊所登记的2型糖尿病（T2D）患者的人口统计学差异，并评估他们接受的护理质量。设计：横断面观察性研究。背景：来自新西兰奥克兰和怀卡托地区四个大型初级保健组织的初级保健数据。参与者：2021年2月至2022年8月，年龄在18-75岁的T2D患者。主要结局指标：农村与社会人口变量、临床指标和处方率之间的关系。结果：共纳入56 937例T2D患者，其中85.3%在城市就诊，14.7%在农村就诊。农村诊所Māori个体比例明显高于城市诊所（31.4%比17.4%）。农村诊所的患者平均HbA1c、LDL-c、血压和eGFR的降低低于城市诊所的患者，但没有临床意义；然而，在研究期间，农村诊所完成的实验室检查数量较低。Māori接受HbA1c和uACR测试的可能性低于non-Māori。临床指征二甲双胍处方（79.1% vs. 72.5%）、ACE抑制剂（80.5% vs. 75.2%）和他汀类药物（61.2% vs. 54.4%）在城市诊所的患者中高于农村诊所(均p结论：需要有针对性的策略来解决农村诊所患者T2D护理的差异，以及Māori，特别是优化药物处方和实验室检查以改善整体护理。
{"title":"Type 2 Diabetes Management in Aotearoa New Zealand: A Comparison of Urban and Rural Primary Care Clinics","authors":"Sara Mustafa, Mark Rodrigues, Ross Lawrenson, Jo Scott-Jones, Valentina Papa, Jinru Zhao, Rebekah Crosswell, Tim Kenealy, Rinki Murphy, Rawiri Keenan, Allan Moffitt, Ryan Paul, Lynne Chepulis","doi":"10.1111/ajr.70098","DOIUrl":"10.1111/ajr.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the demographic differences between individuals with Type 2 Diabetes (T2D) enrolled in rural and urban clinics and evaluate the quality of care they receive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Primary care data from four large Primary Healthcare Organisations across the Auckland and Waikato regions of New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients aged 18–75 years with T2D from February 2021 to August 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Associations between rurality and sociodemographic variables, clinical measures, and prescribing rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 56 937 patients with T2D were included, with 85.3% enrolled in urban practices and 14.7% in rural. Rural clinics had a significantly higher proportion of Māori individuals than urban clinics (31.4% vs. 17.4%). Patients in rural clinics had lower but not clinically significant reductions in mean HbA1c, LDL-c, blood pressure, and eGFR than those in urban clinics; however, the number of laboratory tests completed during the study period was lower in rural clinics. Māori were less likely to receive HbA1c and uACR tests than non-Māori. Clinically indicated prescribing for metformin (79.1% vs. 72.5%), ACE inhibitors (80.5% vs. 75.2%), and statins (61.2% vs. 54.4%) was higher in patients enrolled in urban than rural clinics (all <i>p</i> < 0.05), and regression showed lower odds of insulin (OR: 0.65, 95% CI: 0.61–0.69) and SGLT2i/GLP1RA (OR: 0.87, 95% CI: 0.82–0.93) prescribing in rural clinics (both <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Targeted strategies are needed to address the disparities in T2D care for patients in rural clinics, as well as Māori, particularly optimizing medication prescribing and laboratory tests to improve overall care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alice Cairns, Kylie Stothers (Jawoyn), Paul Gibson, James Debenham, Stephanie Topp, Narelle Campbell, Lauren Toll, Heather Malcolm, Jena Stephen
Aim
To propose the novel role of Aboriginal and/or Torres Strait Islander Allied Health Co-Worker to address an urgent unmet need in rural and remote Australia that focuses on disability, rehabilitation and preventative health needs in a unique cultural context.
Context
Allied health and therapy assistants represent a rapidly expanding workforce with considerable potential to relieve workforce shortages and address urgent and unmet healthcare needs in rural and remote Australia. However, the current recognised roles of “Allied Health Assistant” or “Therapy Assistant” are incompatible with the needs of the Aboriginal and Torres Strait Islander communities.
Approach
This commentary prosecutes the case that for Aboriginal and Torres Strait Islander families and communities, the allied health assistant role should be adapted to an Aboriginal and/or Torres Strait Islander Allied Health Co-Worker (AHCW). The AHCW would provide allied health clinical care within the scope of an allied health assistant, as well as cultural brokerage and leadership to support the cultural needs of the people and communities with which the services are interacting. Recommendations are proposed for sustainable implementation of this role.
Conclusion
It is proposed that Aboriginal and/or Torres Strait Islander Allied Health Co-Workers' roles and appropriate recognition of their cultural leadership roles be introduced and embedded in health and disability employment policies.
{"title":"Aboriginal and/or Torres Strait Islander Allied Health Co-Workers: A Possible Role in Advancing Aboriginal and Torres Strait Islander Health and Well-Being","authors":"Alice Cairns, Kylie Stothers (Jawoyn), Paul Gibson, James Debenham, Stephanie Topp, Narelle Campbell, Lauren Toll, Heather Malcolm, Jena Stephen","doi":"10.1111/ajr.70096","DOIUrl":"https://doi.org/10.1111/ajr.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To propose the novel role of Aboriginal and/or Torres Strait Islander Allied Health Co-Worker to address an urgent unmet need in rural and remote Australia that focuses on disability, rehabilitation and preventative health needs in a unique cultural context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Allied health and therapy assistants represent a rapidly expanding workforce with considerable potential to relieve workforce shortages and address urgent and unmet healthcare needs in rural and remote Australia. However, the current recognised roles of “Allied Health Assistant” or “Therapy Assistant” are incompatible with the needs of the Aboriginal and Torres Strait Islander communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>This commentary prosecutes the case that for Aboriginal and Torres Strait Islander families and communities, the allied health assistant role should be adapted to an Aboriginal and/or Torres Strait Islander Allied Health Co-Worker (AHCW). The AHCW would provide allied health clinical care within the scope of an allied health assistant, as well as cultural brokerage and leadership to support the cultural needs of the people and communities with which the services are interacting. Recommendations are proposed for sustainable implementation of this role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is proposed that Aboriginal and/or Torres Strait Islander Allied Health Co-Workers' roles and appropriate recognition of their cultural leadership roles be introduced and embedded in health and disability employment policies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tracey Edwards, David Garne, Lyndal Parker-Newlyn, Rowena G. Ivers, Judy Mullan, Kylie J. Mansfield, Andrew Bonney, Colin H. Cortie
Objective
To examine differences and changes in workplace and demographic factors between metropolitan and rural surgeons in Australia over 10 years.
Methods
A retrospective study which analysed data from the Health Workforce Dataset Online Data Tool, based on annual registration data from the Australian Health Practitioner Regulation Agency (AHPRA) spanning 2013–2022. The dataset includes information on all surgeons who have completed their training and are registered as fellows with the Royal Australasian College of Surgeons, and who were working in Australia during the study period. The factors analysed included mean hours worked per week, gender, age, and origin of qualification. Regions of work were defined using the Modified Monash Model (MM) model.
Results
During the study period, the number of surgical fellows in Australia increased from 4568 to 5724, with a notable increase in the proportion working in metropolitan regions. On average, these surgeons worked 45 h per week across most regions. The percentage of female surgeons rose from 9.6% to 15.4% in metropolitan regions and from 6.9% to 12.4% in rural regions. Surgeons working in rural regions tended to be older. However, there has been an increase in the number of surgeons aged 35–44 working in these areas. Additionally, sub-specialties other than general surgery were rarely found in rural areas.
Conclusion
While the number of surgeons in Australia has increased, there is a disproportionate shortfall of surgeons practising in rural areas.
{"title":"Surgeons Outside of Cities: Longitudinal Trends in the Surgical Workforce of Rural Australia From 2013 to 2022","authors":"Tracey Edwards, David Garne, Lyndal Parker-Newlyn, Rowena G. Ivers, Judy Mullan, Kylie J. Mansfield, Andrew Bonney, Colin H. Cortie","doi":"10.1111/ajr.70097","DOIUrl":"https://doi.org/10.1111/ajr.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine differences and changes in workplace and demographic factors between metropolitan and rural surgeons in Australia over 10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study which analysed data from the Health Workforce Dataset Online Data Tool, based on annual registration data from the Australian Health Practitioner Regulation Agency (AHPRA) spanning 2013–2022. The dataset includes information on all surgeons who have completed their training and are registered as fellows with the Royal Australasian College of Surgeons, and who were working in Australia during the study period. The factors analysed included mean hours worked per week, gender, age, and origin of qualification. Regions of work were defined using the Modified Monash Model (MM) model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, the number of surgical fellows in Australia increased from 4568 to 5724, with a notable increase in the proportion working in metropolitan regions. On average, these surgeons worked 45 h per week across most regions. The percentage of female surgeons rose from 9.6% to 15.4% in metropolitan regions and from 6.9% to 12.4% in rural regions. Surgeons working in rural regions tended to be older. However, there has been an increase in the number of surgeons aged 35–44 working in these areas. Additionally, sub-specialties other than general surgery were rarely found in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While the number of surgeons in Australia has increased, there is a disproportionate shortfall of surgeons practising in rural areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julian Ming, Helen Bartholomew, David Preen, John Fisher, Tom Briffa, Andrew Hooper, James M. Rankin, Abdul Rahman Ihdayhid, Derrick Lopez
Objectives
Determine counts, characteristics and outcomes following transport by the Royal Flying Doctor Service Western Operations (RFDSWO) to Perth.
Study Design
Retrospective cohort study of the RFDSWO aeromedical patient dataset linked to administrative datasets.
Participants
Suspected acute coronary syndrome (ACS) patients aged ≥ 25 years transported from rural Western Australia to Perth between 2001 and 2017.
Main Outcome Measures
Basic counts and proportions. Poisson regression was used to determine absolute change in number of transports and relative risk (RR) of receiving diagnostic coronary angiography; logistic regression to model odds ratio (OR) of death between transport and end of hospital care.
Results
RFDSWO carried out 11 390 transports for suspected ACS between 2001 and 2017, with the absolute number of annual transports increasing by 6.0%. After excluding 164 transports without linked records, the remaining 11 226 consisted of patients with a mean age of 60.3 years and 70.8% male. Most (99.1%) were hospitalised and 1.8% died. Among those hospitalised, 84.5% received diagnostic coronary angiography and 74.5% were discharged with a diagnosis of ACS. Females (RR = 0.97; CI = 0.95–0.99), higher comorbidity scores, and those from the Pilbara/Midwest/Wheatbelt regions (compared to South West) were less likely to receive diagnostic coronary angiography. Older patients (OR = 1.07; CI = 1.06–1.11), earlier transport years, higher comorbidity scores, those with priority 1 transport or requiring medical escort, and those from the Kimberley (compared to South West) were more likely to die.
Conclusions
Findings suggest a high suspicion of coronary artery pathology among transported patients. Patient-level and regional differences in outcomes warrant further investigation with more granular data.
目的：确定由皇家飞行医生服务西部业务（RFDSWO）运送到珀斯后的数量、特征和结果。研究设计：对RFDSWO航空医疗患者数据集与行政数据集相关联的回顾性队列研究。参与者：2001年至2017年间从西澳大利亚农村转移到珀斯的年龄≥25岁的疑似急性冠脉综合征（ACS）患者。主要结果测量：基本计数和比例。使用泊松回归确定接受诊断性冠状动脉造影的转运数和相对危险度（RR）的绝对变化；logistic回归分析运输与医院护理结束之间的死亡率比值比（OR）。结果：2001 - 2017年，RFDSWO对疑似ACS进行了11 390次转运，年转运绝对数量增加了6.0%。在排除164例无相关记录的转运后，剩余的11226例患者平均年龄为60.3岁，70.8%为男性。大多数（99.1%）住院，1.8%死亡。在住院患者中，84.5%接受了诊断性冠状动脉造影，74.5%诊断为ACS出院。女性（RR = 0.97; CI = 0.95-0.99）、较高的共病评分以及来自皮尔巴拉/中西部/小麦带地区（与西南地区相比）的患者接受诊断性冠状动脉造影的可能性较小。年龄较大的患者（OR = 1.07; CI = 1.06-1.11）、较早的转运年份、较高的共病评分、优先转运或需要医疗护送的患者以及来自金伯利的患者（与西南地区相比）更容易死亡。结论：研究结果提示转运患者对冠状动脉病变有很高的怀疑。患者水平和地区差异的结果值得进一步研究更细粒度的数据。
{"title":"Counts, Characteristics and Outcomes of Patients Transported by the Royal Flying Doctor Service to Metropolitan Perth With Suspected Acute Coronary Syndrome: Western Australian Linked Data Study","authors":"Julian Ming, Helen Bartholomew, David Preen, John Fisher, Tom Briffa, Andrew Hooper, James M. Rankin, Abdul Rahman Ihdayhid, Derrick Lopez","doi":"10.1111/ajr.70093","DOIUrl":"10.1111/ajr.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Determine counts, characteristics and outcomes following transport by the Royal Flying Doctor Service Western Operations (RFDSWO) to Perth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Retrospective cohort study of the RFDSWO aeromedical patient dataset linked to administrative datasets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Suspected acute coronary syndrome (ACS) patients aged ≥ 25 years transported from rural Western Australia to Perth between 2001 and 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Basic counts and proportions. Poisson regression was used to determine absolute change in number of transports and relative risk (RR) of receiving diagnostic coronary angiography; logistic regression to model odds ratio (OR) of death between transport and end of hospital care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RFDSWO carried out 11 390 transports for suspected ACS between 2001 and 2017, with the absolute number of annual transports increasing by 6.0%. After excluding 164 transports without linked records, the remaining 11 226 consisted of patients with a mean age of 60.3 years and 70.8% male. Most (99.1%) were hospitalised and 1.8% died. Among those hospitalised, 84.5% received diagnostic coronary angiography and 74.5% were discharged with a diagnosis of ACS. Females (RR = 0.97; CI = 0.95–0.99), higher comorbidity scores, and those from the Pilbara/Midwest/Wheatbelt regions (compared to South West) were less likely to receive diagnostic coronary angiography. Older patients (OR = 1.07; CI = 1.06–1.11), earlier transport years, higher comorbidity scores, those with priority 1 transport or requiring medical escort, and those from the Kimberley (compared to South West) were more likely to die.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest a high suspicion of coronary artery pathology among transported patients. Patient-level and regional differences in outcomes warrant further investigation with more granular data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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