scholarly journals Rural and urban general practice: a comparison in 34 countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Groenewegen ◽  
M Bosmans ◽  
W Boerma
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Care Services ◽  
Multilevel Regression ◽  
Rural And Urban Areas ◽  
Care Services ◽  
Rural And Urban ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background Rural areas have problems in attracting and retaining primary care workforce. Comparable problems but with a different background occur in deprived urban areas. Here we focus on primary care practices that do work in rural areas and not on the shortage or lack of access for the rural population. We answer the question whether these practices have a different organisation, lack resources and have different service profiles, compared to practices in semi-rural and urban areas. Methods We used data from the QUALICOPC study, conducted among approximately 7,000 GPs in 34 (mainly European) countries, on the organisation of practices, their human resources and equipment and their service profiles. Data were analysed using multilevel regression analysis, with countries and GPs as levels. Results In general the practices in rural areas are more often single-handed and have less other primary care workers available. In most countries they have more equipment and their service profiles are broader, in particular as compared to inner-city urban practices. Conclusions The combination of increasing demand for care and undersupply of health care services can lead to a primary care shortage in rural areas. However, the practices that are currently located in rural area in most countries seem to be able to cope with the situation by providing a broader range of services, compared to service-rich urban areas. Against growing health needs of an ageing and often poorer population, there is a risk of lack of facilities and equipment and ageing staff. Until now this is not manifest in the primary care practices in most countries.

Nurse Practitioner Autonomy and Complexity of Care in Rural Primary Care

2020 ◽  
pp. 107755872094591
Author(s):  
Hannah T. Neprash ◽  
Laura Barrie Smith ◽  
Bethany Sheridan ◽  
Ira Moscovice ◽  
Shailendra Prasad ◽  
...  
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Rural Primary Care ◽  
Rural And Urban ◽  
Clinical Autonomy ◽  
Care Practices ◽  
Primary Care Practices

The growing ranks of nurse practitioners (NPs) in rural areas of the United States have the potential to help alleviate existing primary care shortages. This study uses a nationwide source of claims- and EHR-data from 2017 to construct measures of NP clinical autonomy and complexity of care. Comparisons between rural and urban primary care practices reveal greater clinical autonomy for rural NPs, who were more likely to have an independent patient panel, to practice with less physician supervision, and to prescribe Schedule II controlled substances. In contrast, rural and urban NPs provided care of similar complexity. These findings provide the first claims- and EHR-based evidence for the commonly held perception that NPs practice more autonomously in rural areas than in urban areas.

scholarly journals Rural-urban differences in the pattern of referrals to an asynchronous teledermatology service

10.3823/2571 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Josep Vidal-Alaball ◽  
Jacobo Mendioroz Peña ◽  
Glòria Sauch Valmaña
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Face To Face ◽  
Rural Primary Care ◽  
Primary Care Teams ◽  
The Face ◽  
Care Practices ◽  
Urban And Rural Areas ◽  
Primary Care Practices

Background Telemedicine is particularly useful in rural areas where can facilitate access to specialised care in regions far from urban hospitals and can prevent unnecessary travel. The purpose of this research was to evaluate the degree of resolution of an asynchronous teledermatology service in the Bages County, comparing urban and rural primary care centres. Methods and findings A longitudinal descriptive study of referrals from 14 Primary Care Teams to a hospital dermatology service as a result of a previous referral to a teledermatology program was performed, comparing years 2015 and 2016 and urban with rural practices. Both in urban and rural areas there was an increase in referrals to the teledermatology service in 2016 compared to the previous year (12.9% and 0.3% respectively). In the two years analysed, referral rates to the teledermatology service per thousand inhabitants from rural centres was statistically much higher than that of urban centres (p<0.001). The number of referrals to the face-to-face dermatology service after a teledermatology consultation decreased significantly in both urban [OR=0,81 (0,70-0,93) p=0,001] and rural centres [OR=0,64 (0,57-0,72) p<0,001]. Conclusions The asynchronous teledermatology service established in the Bages County increases the resolution of primary care teams as reduces referrals to the face-to-face dermatology service. This effect is more pronounced in rural than in urban areas. Such finding may indicate the need to prioritize telemedicine services in rural primary care practices.

scholarly journals The primary care workforce in Europe: a cross-sectional international comparison of rural and urban areas and changes between 1993 and 2011

2020 ◽  
Vol 30 (Supplement_4) ◽  
pp. iv12-iv17 ◽  
Author(s):  
Peter P Groenewegen ◽  
Mark W G Bosmans ◽  
Wienke G W Boerma ◽  
Peter Spreeuwenberg
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Procedures ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Primary Care Workforce ◽  
Practice Population ◽  
The Individual

Abstract Rural areas have problems in attracting and retaining primary care workforce. This might have consequences for the existing workforce. We studied whether general practitioners (GPs) in rural practices differ by age, sex, practice population and workload from those in less rural locations and whether their practices differ in resources and service profiles. We used data from 2 studies: QUALICOPC study collected data from 34 countries, including 7183 GPs in 2011, and Profiles of General Practice in Europe study collected data from 32 countries among 7895 GPs in 1993. Data were analyzed using multilevel analysis. Results show that the share of female GPs has increased in rural areas but is still lower than in urban areas. In rural areas, GPs work more hours and provide more medical procedures to their patients. Apart from these differences between locations, overall ageing of the GP population is evident. Higher workload in rural areas may be related to increased demand for care. Rural practices seem to cope by offering a broad range of services, such as medical procedures. Dedicated human resource policies for rural areas are required with a view to an ageing GP population, to the individual preferences and needs of the GPs, and to decreasing attractiveness of rural areas.

Poliligotumo paplitimo dinamika ir ambulatorinių sveikatos priežiūros paslaugų suvartojimas klaipėdos apskrities kaimo ir miesto populiacijose

2013 ◽  
Vol 23 (1) ◽  
pp. 173-178
Author(s):  
Arnoldas Jurgutis ◽  
Laura Kubiliutė ◽  
Arvydas Martinkėnas ◽  
Jelena Filipova ◽  
Alfridas Bumblys
Keyword(s):  
Health Care ◽  
Urban Areas ◽  
Health Care Services ◽  
Population Data ◽  
Rural And Urban Areas ◽  
Care Services ◽  
Rural And Urban ◽  
Co Morbidity ◽  
Patient Health ◽  
Research Population

The aim of the study: to evaluate multi-morbidity dynamics, and needs of out-patient health care services in rural and urban areas in Klaipeda region during years 2009-2011.An observational retrospective study was performed using non-personalized population data from the Klaipeda TerritorialSickness Fund database. The research population included approximately 410 000 patients, enlisted to 44 primary health care institutions in Klaipeda region during the years 2009-2011. Johns Hopkins ACG system was used to group the population into six Resource Utilization Bands (RUB) which range from non-users (RUB 0) to a very high co-morbidity group (RUB 5). The study revealed that during the investigation period (2009-2011) prevalence of multi-morbidity (RUB 5) increased from 9.5/1000 to 9.6/1000 patients (statistically insignificant). In year 2009 and 2010 more multi-morbid patients were in urban population (p&lt;0.05), but the trend of multi-morbidity prevalence in rural and urban populations was statistically insignificant. Patients from urban areas used more specialist (secondary and tertiary health care) services when compared with rural population.

MULTI - DIMENSIONAL ROLE OF A PHARMACIST IN HOSPITAL: A HEALTH CARE PROVIDER

2018 ◽  
pp. 5-7
Author(s):  
Singh S ◽  
Virmani T ◽  
Virmani R ◽  
Geeta . ◽  
Gupta J
Keyword(s):  
Health Care ◽  
Urban Areas ◽  
Health Care Services ◽  
Drug Product ◽  
Hospital Pharmacist ◽  
Therapeutic Monitoring ◽  
Direct Patient Care ◽  
Rural And Urban Areas ◽  
Rural And Urban

The objective of this study was to point out multi-dimensional role of a pharmacist with a special emphasis on the hospital pharmacist. Apharmacist is a person who is involved in designing, creating or manufacturing of a drug product, dispensing of a drug, managing and planning ofa pharmaceutical care. They are experts on the action and uses of drugs, including their chemistry, pharmacology and formulation. Theprofessional life of a hospital pharmacist might seem insignificant as compared to that of doctors, but actually they are highly trained healthprofessionals who plays important role in patient safety, patient compliance, therapeutic monitoring and even in direct patient care. With thepassage of time and advancements in health care services and pharmaceuticals, the role of a hospital pharmacist has become more diversified. Toa career, a hospital pharmacist must possess a diploma/degree in pharmacy from an accredited pharmacy college and must be registered with thestate pharmacy council of their respective region. In this study, we have assessed the behavior, communication skills, qualifications of thepharmacist, prescription handling ability and other factors to evaluate the diversified role of hospital pharmacist and their comparison withpharmacists practicing in rural and urban areas. Current surveys show that the pharmacists are not practicing as per the standard due to lack ofproper guidelines and watch over their practicing sense. The rules and guidelines prescribed by the Food and drug administration (FDA) andIndian pharmacopeia commission (IPC) were not followed by the pharmacist.

TURNING FARMERS INTO SOCIAL FARMER ENTREPRENEURS FOR DISADVANTAGED PEOPLE

2020 ◽  
Author(s):  
Remus Runcan
Keyword(s):  
Rural Communities ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Health And Safety ◽  
Physical Work ◽  
Healthy Environment ◽  
Rural And Urban Areas ◽  
Rural Development Programme ◽  
Rural And Urban

According to Romania’s National Rural Development Programme, the socio-economic situation of the rural environment has a large number of weaknesses – among which low access to financial resources for small entrepreneurs and new business initiatives in rural areas and poorly developed entrepreneurial culture, characterized by a lack of basic managerial knowledge – but also a large number of opportunities – among which access of the rural population to lifelong learning and entrepreneurial skills development programmes and entrepreneurs’ access to financial instruments. The population in rural areas depends mainly on agricultural activities which give them subsistence living conditions. The gap between rural and urban areas is due to low income levels and employment rates, hence the need to obtain additional income for the population employed in subsistence and semi-subsistence farming, especially in the context of the depopulation trend. At the same time, the need to stimulate entrepreneurship in rural areas is high and is at a resonance with the need to increase the potential of rural communities from the perspective of landscape, culture, traditional activities and local resources. A solution could be to turn vegetal and / or animal farms into social farms – farms on which people with disabilities (but also adolescents and young people with anxiety, depression, self-harm, suicide, and alexithymia issues) might find a “foster” family, bed and meals in a natural, healthy environment, and share the farm’s activities with the farmer and the farmer’s family: “committing to a regular day / days and times for a mutually agreed period involves complying with any required health and safety practices (including use of protective clothing and equipment), engaging socially with the farm family members and other people working on and around the farm, and taking on tasks which would include working on the land, taking care of animals, or helping out with maintenance and other physical work”

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

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