Background
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Birth rates within communities
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Geographic factors such as remoteness
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Socioeconomic factors including community levels of disadvantage
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Links to medical specialists
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Resourcing and service capability
Methods
Literature review
All Search terms used
RuralRural populationRural and remote healthRural and remote health servicesRural health services, access and indexRural health services and models/modellingRural health services/Rural hospital, levels of serviceHealth service planning,Accessibility, accessHealth service accessibilityAccessibility Regional Health Planning/Need, rural populationsrural, remote health service planningHealth service deliveryMaternity servicesRural and remote maternity servicesPregnancy/or Maternal Health Services/or Australia/or Midwifery/women's health services/or "health care quality, access, and evaluation"geographical, geography access and health.Access, Transport- rural, Geographical information systems (GIS) and accessibility of health servicesAustralia, UK, Canada, Scotland, New ZealandDecision Making, Index, modelling, models, tools, decision making tools and frameworks
Rural health servicesMaternity health servicesHospital catchments, health service catchmentsEmergency transfers and maternity Transportation of Patients" Emergency Medical Services, Patient Transfer, pregnancy, perinatal care, Inter-hospital transfers and outcomes, Aeromedical Retrievals and maternity services, RFDS, rural and remote transfers, delivery of health careQuality of Health Care", Obstetric Labor Complications/Delivery, Obstetric/Obstetrics/Pregnancy Complications/Pregnancy/Maternal Mortality/Maternal Health Services/Health Services Accessibility childbirth or pregnancy complications or rural areas or prematurity or mothers or healthInfant, Newborn/ or Pregnancy/or Prenatal Care/or Maternal Health Services/or Mothers/or Midwifery/or Obstetrics/Distance and time travelled and accessaccessibility, GIS and rural health servicesSocioeconomic status, needIsolation, indigenous, travel and maternal outcome, remote area health and outcome, remote area health and perinatal outcomes,maternal health services/or perinatal care/or preconception care/or prenatal care/or health services, indigenous/or "health care quality, access, and evaluation"
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Humans only
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English Language
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1990- current
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Inform access to a level or type of service in rural and remote communities in high income countries
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Were congruent with the factors listed in the NMSP
Results
Index | 1. Rural birth index [ [17]] | 2. Trauma model [ [24]] | 3. Index of rural access [ [23]] | 4. Cardiac aria index [ [22]] |
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Service
| Maternity | Trauma | GP* services | Cardiac emergency & cardiac rehabilitation |
Level or capability of service
| levels of maternity service dependent on level of staff and procedural care available | Level of trauma service- I,II,III- complexity of trauma care | Primary care services | **AIHW Hospital types large -small including community level services |
Population
| Rural British Columbia, Canada | Rural British Columbia, Canada | Rural Victoria, Australia | Total Australian- rural and urban pop locations (20,387) |
Catchment
| 60 minute to a ***CS service | 60 minute to a trauma service | Ration of *GPs to population in a 60 minute catchment | Population access to a service within 60 minutes for an emergency cardiac response |
Index Specific
| Birth numbers within the 60 minute catchment of a service with ***CS capability | Risk of trauma, ^SES and access to trauma service | Ratio of *GP services to population in a 60 minute catchment | Access to emerg care in a cardiac event and for cardiac rehabilitation |
Isolation
| Seven categories of time <30 min- >4 hrs to a service with CS capability | travel time to trauma centre- highest quintile of need assigned to least serviced communities (metro excluded) | 60 min catchments- ‘distance decay’ after 10 minutes | Decreasing levels of services as remoteness increases- 8 levels hospital |
Vulnerability
| 1 data set ^SES advantage-disadvantage | ^^VANDIX ^^^SEFI | 6 SES measures that impact health outcomes including: Indigenous & #CALD included | N/A |
^SES vulnerability to trauma | ||||
Emergency treatment
| one hour an important threshold for emergency care | One hour critical time to treatment for trauma | N/A | One hour critical time to treatment in a cardiac event |