Paynter Jessica A, Qin Kirby R, Hunter-Smith David, Brennan Janelle, Rozen Warren
Department of Surgery, Monash University School of Rural Health, Clayton, Victoria, Australia.
Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia.
ANZ J Surg. 2024 Dec;94(12):2231-2237. doi: 10.1111/ans.19229. Epub 2024 Sep 12.
Australia continues to suffer from a geographical maldistribution of general surgical services with only 20% of general surgeons working rurally despite 29% of Australia's population residing outside major metropolitan centres. This qualitative study explored the impact of human capacity and infrastructure upon rural general surgery provision.
This qualitative study employed semi-structured interviews of rural general surgeons. Participants were recruited via the Royal Australasian College of Surgeons (RACS) Rural newsletter and purposive sampling. All interviews were conducted between January 2023 and April 2023. Transcripts were transcribed, de-identified, and thematically analysed.
Two female and 20 male rural general surgeons were interviewed from seven of the eight Australian State or Territories. Four main themes were identified which reflected the impact of human capacity and infrastructure upon Australian rural general surgery provision: (1) small hospital syndrome - and the impact, (2) the rural general surgeon identity, (3) infrastructure and disempowerment and (4) over-reliance on visiting surgeons.
Improving access to equitable general surgical care for rural Australians requires appropriate infrastructure and a well-trained, sustainable multidisciplinary surgical team (human capacity). A greater understanding of the issues may help drive rational, long-term supportive solutions.
澳大利亚普通外科服务的地理分布仍然不均衡，尽管澳大利亚29%的人口居住在主要大城市中心以外，但只有20%的普通外科医生在农村地区工作。这项定性研究探讨了人力和基础设施对农村普通外科服务提供的影响。
这项定性研究采用了对农村普通外科医生的半结构化访谈。参与者通过澳大利亚皇家外科学院（RACS）的农村通讯和目的抽样进行招募。所有访谈均在2023年1月至2023年4月期间进行。访谈记录被转录、去识别化并进行主题分析。
从澳大利亚八个州或领地中的七个州采访了两名女性和二十名男性农村普通外科医生。确定了四个主要主题，反映了人力和基础设施对澳大利亚农村普通外科服务提供的影响：（1）小医院综合征及其影响，（2）农村普通外科医生的身份，（3）基础设施与权力剥夺，以及（4）过度依赖来访外科医生。
改善澳大利亚农村居民获得公平普通外科护理的机会需要适当的基础设施和一支训练有素、可持续的多学科外科团队（人力）。对这些问题有更深入的了解可能有助于推动合理的长期支持性解决方案。
