Sunday, 17 July 2016

Delivering healthcare to where it’s needed: subsidies for specialist outreach services are key

SPHPM PhD candidate Dr Belinda O’Sullivan under the supervision of Professor Just Stoelwinder and Senior Research Fellow Dr Matthew McGrail from Monash Rural Health have led important new research evaluating the success of subsidies for specialists travelling to provide outreach services to see patients in rural and remote locations.

The study was based on the Medicine in Australia: Balancing Employment and Life (MABEL) study which is a unique survey for studying the impact of policy on practice. The researchers were able to compare which groups were more likely to provide outreach services; those who were subsidised and those who weren’t. Specifically they evaluated the influence of the Australian Government Rural Health Outreach Fund (RHOF) compared with specialists subsidised through other sources.

Belinda’s PhD established rural outreach work is undertaken by approximately one in five specialists in Australia, but only 16 percent of those specialists participating provide services to remote locations.

In Australia, where population densities are small and distances can be extreme, travelling to provide care closer to communities is both expensive and time consuming.

Many Australian studies have corroborated that rural and remote health outcomes are significantly poorer due to limited access to health services, and outreach services have been identified as a key strategy for improving access to medical specialists.

“Nearly half of the specialists in the study reported receiving subsidies for the costs of outreach service provision, and this was relatively evenly split between subsidies from the Australian Government RHOF and subsidies from another source,” said Dr O’Sullivan.

“However we did see that those doctors receiving subsidies travelled for longer and provided more remote services which suggests subsidies like the RHOF are vital to increase targeted and stable outreach services in areas of highest relative need,” said Professor Stoelwinder.

In addition, compared with specialists with no subsidies, RHOF-subsidised specialists worked in priority areas and provided equally regular services, which they said they intended to continue despite visiting more remote locations.

“We have worked hard to make sure the results are accessible to rural workforce agencies, specialists and the Australian government who funds the RHOF,” said Dr O’Sullivan.

The study was published last month in the Australian Health Review and can be accessed here.