School of Medicine, Deakin University, Geelong 3220, Australia.
Department of Rural Health, University of South Australia, Whyalla 5608, Australia.
Int J Environ Res Public Health. 2022 Jan 27;19(3):1438. doi: 10.3390/ijerph19031438.
Redressing the maldistribution of the health workforce in regional, rural, and remote geographical areas is a global issue and crucial to improving the accessibility of primary health care and specialist services. Geographical classification systems are important as they provide an objective and quantifiable measure of access and can have direct policy relevance, yet they are not always consistently applied in rural health research. It is unclear how research focusing on the graduate health workforce in Australia has described, measured, and analyzed place of practice. To examine approaches used, this review systematically scopes Australian rural studies focusing on dentistry, medicine, nursing, and allied health graduates that have included place of practice as an outcome measure. The Joanna Brigg's Institute Scoping Review Methodology was used to guide the review. Database searches retrieved 1130 unique citations, which were screened, resulting in 62 studies for inclusion. Included studies were observational, with most focusing on the practice locations of medical graduates and predicators of rural practice. Variations in the use of geographical classification approaches to define rurality were identified and included the use of systems that no longer have policy relevance, as well as adaptations of existing systems that make future comparisons between studies challenging. It is recommended that research examining the geographical distribution of the rural health workforce use uniform definitions of rurality that are aligned with current government policy.
纠正卫生人力在区域、农村和偏远地区的分布不均是一个全球性问题,对于改善基本医疗保健和专科服务的可及性至关重要。地理分类系统很重要,因为它们提供了可衡量的获取途径的客观指标,并且可能具有直接的政策相关性,但在农村卫生研究中并非总是一致应用。目前尚不清楚澳大利亚研究生卫生人力的研究重点如何描述、衡量和分析实践地点。为了研究所采用的方法,本综述系统地探讨了澳大利亚农村地区牙科、医学、护理和联合健康专业毕业生的研究,这些研究将实践地点作为结果衡量标准。乔安娜·布里格斯研究所(Joanna Brigg's Institute)的范围综述方法用于指导综述。数据库检索共获得 1130 条独特的引用,经过筛选,纳入了 62 项研究。纳入的研究是观察性的,其中大多数集中在医学毕业生的实践地点和农村实践的预测因素上。确定了用于定义农村地区的地理分类方法的使用存在差异,包括使用不再具有政策相关性的系统,以及对现有系统的调整,这使得未来研究之间的比较具有挑战性。建议研究农村卫生人力地理分布的研究使用与当前政府政策一致的农村地区统一定义。