A review of rural and remote health service indexes: are they relevant for the development of an Australian rural birth index?

BMC Health Services Research

Lesley Barclay¹  Sue Kruske²  Jennifer Pilcher¹ 

[1] University Centre for Rural Health, University of Sydney, Uralba st, Lismore, NSW, Australia;University Centre for Mothers and Babies, University of Queensland, St Lucia, Brisbane, Australia

关键词: National maternity services plan;    Rural and remote;    Maternity services;    Indexes;   

Others  :  1090142
DOI  :  10.1186/s12913-014-0548-7

 received in 2013-09-26, accepted in 2014-10-22,  发布年份 2014

【 摘 要 】

Background

Policy informs the planning and delivery of rural and remote maternity services and influences the perinatal outcomes of the 30 per cent of Australian women and their babies who live outside the major cities. Currently however, there are no planning tools that identify the optimal level of birthing services for rural and remote communities in Australia. To address this, the Australian government has prioritised the development of a rigorous methodology in the Australian National Maternity Services Plan to inform the planning of rural and remote maternity services.

Methods

A review of the literature was undertaken to identify planning indexes with component variables as outlined in the Australian National Maternity Services Plan. The indexes were also relevant if they described need associated with a specific type and level of health service in rural and remote areas of high income countries. Only indexes that modelled a range of socioeconomic and or geographical variables, identified access or need for a specific service type in rural and remote communities were included in the review.

Results

Four indexes, two Australian and two Canadian met the inclusion criteria. They used combinations of variables including: geographical placement of services; isolation from services and socioeconomic vulnerability to identify access to a type and level of health service in rural and remote areas within 60 minutes. Where geographic isolation reduces access to services for high needs populations, additional measures of disadvantage including indigeneity could strengthen vulnerability scores.

Conclusion

Current planning indexes are applicable for the development of an Australian rural birthing index. The variables in each of the indexes were relevant, however use of flexible sized catchments to accurately account for population births and weighting for extreme geographic isolation needs to be considered. Additionally, socioeconomic variables are required that will reflect need for services particularly for isolated high needs populations. These variables could be used with Australian data and appropriate cut-off points to confirm applicability for maternity services. All of the indexes used similar types of variables and are relevant for the development of an Australian Rural Birth Index.

【 授权许可】

   
2014 Pilcher et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Li Z, Zeki R, Hilder L, Sullivan EA: Australia’s Mothers and Babies 2010. In Perinatal Statistics Series no 27 CAT no PER 57. AIHW National Perinatal Epidemiology and Statistics Unit, Canberra; 2012.
• [2]Arnold JL, de Costa CM, Howat PW: Timing of transfer for pregnant women from Queensland Cape York communities to Cairns for birthing. Med J Aust 2009, 190(10):594-596.
• [3]Lisonkova S, Sheps SB, Janssen PA, Lee SK, Dahlgren L, Macnab YC: Birth outcomes among older mothers in rural versus urban areas: a residence-based approach. J Rural Health 2011, 27(2):211-219.
• [4]Grzybowski S, Stoll K, Kornelsen J: Distance matters: a population based study examining access to maternity services for rural women. BMC Health Serv Res 2011, 11:147. BioMed Central Full Text
• [5]Kelly J, Dwyer J, Willis E, Pekarsky B: Travelling to the city for hospital care: access factors in country aboriginal patient journeys. Aust J Rural Health 2014, 22(3):109-113.
• [6]Sutherns R, Bourgeault IL: Accessing maternity care in rural Canada: there’s more to the story than distance to a doctor. Health Care Women Int 2008, 29(8):863-883.
• [7][http://www.qcmb.org.au/media/pdf/Rebirthing%20report.pdf] webcite Hirst C: Re-Birthing: Report of the Review of Maternity Services in Queensland.ᅟ. Brisbane: ᅟ; 2005. .
• [8][http:/ / www.ruralhealth.org.au/ 10thNRHC/ 10thnrhc.ruralhealth.org.au/ papers/ docs/ Evans_Rebecca_C9.pdf] webcite Evans R, Veitch C, Hays R, Clark M, Larkins S: Health Policy: Outcomes for Rural Residents Access to Maternity Care. In 10th National Rural Conference Cairns May. ᅟ: ᅟ; 2009. .
• [9]Access to Primary Health Care Relative to Need for Indigenous Australians In Cat.no. 128. AIHW, AIHW Canberra; 2014.
• [10]Hart JT: The Inverse care law. Lancet 1971, 297(7696):405-412.
• [11]Ross S: An illustration of the “inverse care law”: a commentary on giving birth in Canada: providers of maternity and infant care. J Obstet Gynaecol Can 2005, 27(1):51-53.
• [12][http://www.health.qld.gov.au/publications/documents/2012-guide-to-hsp.pdf] webcite Department of Health: Guide to Health Service Planning Version 2.ᅟ. Edited by Health Department. ᅟ: Queensland Government; 2012. .
• [13]Wilson DW, Couper ID, DeVries E, Reid S, Fish T, Marais BJ: A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas.Rural Remote Health 2009, 9(1060):ᅟ.
• [14]Schuurman N, Randall E, Berube M: A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning. Health Informatics J 2011, 17(4):277-293.
• [15]Kildea S, Kruske S, Barclay L, Tracy S: ‘Closing the Gap’: how maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women. Rural & Remote Health 2010, 10(3):1383.
• [16]National Maternity Services Plan 2010. Commonwealth of Australia, Canberra; 2011.
• [17]Grzybowski S, Kornelsen J, Schuurman N: Planning the optimal level of local maternity service for small rural communities: a systems study in British Columbia. Health Policy 2009, 92(2–3):149-157.
• [18]Morris R, Carstairs V: Which deprivation? A comparison of selected deprivation indexes. J Public Health Med 1991, 13(4):318-326.
• [19]Schuurman N, Bell N, Dunn JR, Oliver L: Deprivation indices, population health and geography: an evaluation of the spatial effectiveness of indices at multiple scales. J Urban Health 2007, 84(4):591-603.
• [20]Roth RR, Barsi EE: The community need index. A new tool pinpoints health care disparities in communities throughout the nation. Health Progress (Saint Louis, Mo) 2005, 86(4):32-38.
• [21]Bell N, Schuurman N, Hayes MV: Using GIS methods of multicriteria analysis to construct socio-economic deprivation indices.Int J Health Geogr 2007, 6(17):ᅟ.
• [22]Coffee N, Turner D, Clark R, Eckert K, Coombe D, Hugo G, van Gaans D, Wilkinson D, Stewart S, Tonkin A: Measuring national accessibility to cardiac services using geographic information systems. Appl Geogr 2012, 34:445-455.
• [23]McGrail MR, Humphreys JS: The index of rural access: an innovative integrated approach for measuring primary care access. BMC Health Serv Res 2009, 9:124. BioMed Central Full Text
• [24]Schuurman N, Bell N, Hameed M, Simons R: A model identifying and ranking need for trauma service in non-metropolitan regions on injury risk and access to services. J Trauma Injury Infection and Critical Care 2007, 65:54-62.
• [25][http:/ / www.health.gov.au/ internet/ main/ publishing.nsf/ Content/ FC3A10DCCCE8CC0BCA257D2A0016CD0E/ $File/ capab.pdf] webcite Australian Health Ministers Advisory Council: National Maternity Services Capability Framework. ᅟ: Commonwealth of Australia Department of Health; 2013. .
• [26]Australian Institute of Health and Welfare: Australian Hospital Statistics 2012–13, Health Services series no. 54 Cat.no HSE 145. Canberra: AIHW; ᅟ.
• [27]NSW Department of Health: Guide to the Role Delineation of Health Services. In ᅟ. 3rd edition. Edited by Statewide Services Development Branch. Sydney: NSW Health Department; 2002.
• [28][http://www.health.wa.gov.au/hrit/docs/clinicalframework.pdf] webcite Government of Western Australia Department of Health: WA Health Clinical Services Framework 2010–2020. ᅟ: WA Department of Health; 2010. .
• [29]Clinical Services Capability Framework for Public and Private Licensed Private Health Facilities v3.1 [http:/ / www.health.qld.gov.au/ clinical-practice/ guidelines-procedures/ service-delivery/ cscf/ modules/ default.asp] webciteQueensland Government, Brisbane; 2012. http://www.health.qld.gov.au/clinical-practice/guidelines-procedures/service-delivery/cscf/modules/default.asp
• [30]Schuurman N, Fiedler RS, Grzybowski SC, Grund D: Defining rational hospital catchments for non-urban areas based on travel-time. Int J Health Geography 2006, 5:43. BioMed Central Full Text
• [31]Pilkington H, Blondel B, Carayol M, Breart G, Zeitlin J: Impact of maternity unit closures on access to obstetrical care: the French experience between 1998 and 2003. Soc Sci Med 2008, 67(10):1521-1529.
• [32]Gjesfjeld CD, Jung J-K: How far?: Using geographical information systems (GIS) to examine maternity care access for expectant mothers in a rural state. Soc Work Health Care 2011, 50(9):682-693.
• [33]Bronstein JM, Morrisey MA: Determinants of rural travel distance for obstetrics.Med Care 1990, 28(9):ᅟ.
• [34]Wilson K, Rosenberg M: Accessibility and the Canadian health care system: squaring perceptions and realities. Health Policy 2004, 67:137-148.
• [35]Li Z, McNally L, Hilder L, Sullivan EA: Australia’s Mothers and Babies 2009. In Perinatal Statistics Series no 25 Cat no PER 52. AIHW National Perinatal Epidemiology and Statistics Unit, Sydney; 2011.
• [36]Graham S, Pulver LRJ, Wang YA, Kelly PM, Laws PJ, Grayson N, Sullivan EA: The urban-remote divide for Indigenous perinatal outcomes. Med J Aust 2007, 186(10):509-512.
• [37]Kornelsen J, Moola S, Grzybowski S: Does distance matter? Increased induction rates for rural women who have to travel for intrapartum care. J Obstet Gynaecol Can 2009, 31(1):21-27.
• [38]Argent V: Pre-hospital risks of the reconfiguration of obstetric services. Clinical Risk 2010, 16(2):52-55.
• [39]Ravelli ACJ, Jager KJ, de Groot MH, Erwich JJHM: Travel time form home to hospital and adverse perinatal outcomes in women at term in the Netherlands.Br J Obstet Gynaecol 2010, ᅟ:ᅟ. doi:10.1111/j.1471-0528.2010.02816.x.
• [40]Parker L, Dickinson HO, Morton-Jones T: Proximity to maternity services and stillbirth risk. Arch Dis Child Fetal Neonatal Ed 2000, 82(2):F167-F168.
• [41]Fatovich DM, Phillips M, Langford SA, Jacobs IG: A comparison of metropolitan vs rural major trauma in Western Australia. Resuscitation 2011, 82(7):886-890.
• [42]Nicholl J, West J, Goodacre S, Turner J: The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emerg Med J 2007, 24(9):665-668.
• [43]Noble M, Wright G: Identifying poverty in rural England. Policy & Politics 2000, 28(3):293-308.
• [44]Joseph KS, Liston RM, Dodds L, Dahlgren L, Allen AC: Socioeconomic status and perinatal outcomes in a setting with universal access to essential health care services. Can Med Assoc 2007, 177(6):583-590.
• [45]Kildea S, Van Wagner V: ‘Birthing on Country’, Maternity Service Delivery Models: A Review of the Literature. [https://www.saxinstitute.org.au/wp-content/uploads/Birthing-on-Country1.pdf] webciteAn Evidence Check Rapid Review Brokered by the Sax Institute on behalf of the Maternity Services Inter-Jurisdictional Committee for the Australian Health Minister’s Advisory Council, Sydney; 2012. https://www.saxinstitute.org.au/wp-content/uploads/Birthing-on-Country1.pdf
• [46]Kruske S: Birthing on Country: The Queensland Context. Queensland Centre for Mothers and Babies for Queensland Health, Brisbane; 2014.
• [47][http:/ / www.abs.gov.au/ AUSSTATS/ abs@.nsf/ Lookup/ 2039.0Main%20Features42006?opendocu ment&tabname=Summary&prodno=2039.0& issue=2006&num=&view=] webcite ᅟ: 2039.0- Information Paper: An introduction to Socio-Economic Indexes for Areas (SEIFA). 2006, ᅟ:ᅟ []
• [48]Comber AJ, Brunsdon C, Radburn R: A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions. Int J Health Geogr 2011, 10:44. BioMed Central Full Text