O'Sullivan Belinda G, McGrail Matthew R, Stoelwinder Johannes U
Monash Rural Health, Office of Research, Level 3, 26 Mercy St, PO Box 666, Bendigo, Victoria, 3550, Australia.
Monash Rural Health, Northways Road, Churchill, Victoria, 3842, Australia.
Hum Resour Health. 2017 Jan 7;15(1):3. doi: 10.1186/s12960-016-0174-z.
The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations.
A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest.
Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%).
Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.
本研究旨在探讨专科医生前往农村提供定期外展服务的原因，以及这些原因是否与（1）受薪或私人按服务收费的执业方式，以及（2）在更偏远地区提供农村外展服务有关。
对2014年澳大利亚医学：平衡就业与生活（MABEL）调查中的专科医生进行了一项全国性横断面研究。提供农村外展服务的专科医生以5分制自我报告他们对参与的五个原因的认同程度。卡方分析测试了认同与感兴趣变量之间的关联。
在567名提供农村外展服务的专科医生中，参与的原因包括拓展业务（54%）、保持与地区的联系（26%）、提供复杂的医疗服务（18%）、为弱势群体提供医疗服务（12%）和支持农村工作人员（6%）。与按服务收费的专科医生相比，受薪专科医生更常因拓展业务而参与（68%对49%）。这个原因也与前往更远的地方以及在偏远地区/偏远位置提供外展服务有关。私人按服务收费的专科医生更常进行外展服务以提供复杂的医疗服务（22%对14%）。
专科医生开展农村外展服务有多种原因，主要是为了补充其主要业务的增长和多样性或保持与地区的联系。围绕专科医生的主要业务构建农村外展服务可能会支持参与并改善服务分配。
