James Cook University, Townsville, Australia.
College of Medicine and Dentistry, James Cook University, Townsville, Australia.
Hum Resour Health. 2018 Nov 21;16(1):62. doi: 10.1186/s12960-018-0332-6.
Contemporary approaches to rural generalist medicine training and models of care are developing internationally as part of an integrated response to common challenges faced by rural and remote health services and policymakers (addressing health inequities, workforce shortages, service sustainability concerns). The aim of this study was to review the literature relevant to rural generalist medicine.
A scoping review was undertaken to answer the broad question 'What is documented on rural generalist medicine?' Literature from January 1988 to April 2017 was searched and, after final eligibility filtering (according to established inclusion and exclusion criteria), 102 articles in English language were included for final analysis.
Included papers were analysed and categorised by geographic region, study design and subject themes. The majority of articles (80%) came from Australia/New Zealand and North America, reflecting the relative maturity of programmes supporting rural generalist medicine in those countries. The most common publication type was descriptive opinion pieces (37%), highlighting both a need and an opportunity to undertake and publish more systematic research in this area. Important themes emerging from the review were: Definition Existing pathways and programmes Scope of practice and service models Enablers and barriers to recruitment and retention Reform recommendations There were some variations to, or criticisms of, the definition of rural generalist medicine as applied to this review, although this was only true of a small number of included articles. Across remaining themes, there were many similarities and consistent approaches to rural generalist medicine between countries, with some variations reflecting environmental context and programme maturity. This review identified recent literature from countries with emerging interest in rural generalist medicine in response to problematic rural health service delivery.
Supported, coordinated rural generalist medicine programmes are being established or developed in a number of countries as part of an integrated response to rural health and workforce concerns. Findings of this review highlight an opportunity to better share the development and evaluation of best practice models in rural generalist medicine.
当代农村全科医学培训方法和医疗模式正在国际上发展，作为对农村和偏远地区卫生服务和政策制定者面临的共同挑战（解决卫生不平等、劳动力短缺、服务可持续性问题）的综合应对措施的一部分。本研究旨在综述农村全科医学的相关文献。
采用范围综述方法，回答了一个广泛的问题，即“农村全科医学方面有哪些文献记载？”检索了 1988 年 1 月至 2017 年 4 月的文献，根据既定的纳入和排除标准进行最终合格性筛选后，纳入了 102 篇英文文献进行最终分析。
纳入的论文按地理区域、研究设计和主题进行了分析和分类。大多数文章（80%）来自澳大利亚/新西兰和北美，反映了这些国家支持农村全科医学项目的相对成熟度。最常见的出版物类型是描述性的意见文章（37%），这既突显了在这一领域进行和发表更系统研究的必要性和机会。从综述中得出的重要主题包括：定义、现有途径和方案、实践范围和服务模式、招聘和留用的促进因素和障碍、改革建议。尽管只有少数几篇文章存在这种情况，但在应用于本次综述的农村全科医学定义方面存在一些差异或批评。在其余的主题中，各国之间存在许多相似之处和对农村全科医学的一致方法，一些差异反映了环境背景和项目成熟度。本综述确定了一些对农村卫生服务提供存在问题的国家最近关于农村全科医学的文献，这些国家对农村全科医学的兴趣正在增强。
在许多国家，支持、协调的农村全科医学方案正在作为对农村卫生和劳动力问题的综合应对措施而建立或发展。本综述的结果突出了在农村全科医学最佳实践模式的发展和评估方面更好地分享经验的机会。
