A comparison study between metropolitan and rural hospital-based telehealth activity to inform adoption and expansion

Introduction In Queensland, Australia, the public hospital system has used telehealth for almost three decades. Although telehealth activity has been growing consistently, there are substantial variations across geographic regions. We explored factors which contribute to this variation in telehealth adoption. Methods This was a multi-method comparative study of two matched metropolitan health services and two matched rural health services. The health services were matched according to the number of providers and hospitals but had different rates of telehealth use. Comparative rates of telehealth visits were analysed using descriptive statistics. Qualitative data was obtained from 63 semi-structured interviews with telehealth administrators, clinicians and senior managers involved in telehealth policies and procedures. Data were analysed using a framework analysis. Results The metropolitan health service that had more telehealth use had greater investment in telehealth, higher population referral areas, highly developed communication strategies and understanding of the value proposition for telehealth, and reported fewer information technology and administration systems difficulties. In rural health services, telehealth activity was influenced by onboarding processes, clinician willingness to practice, strategic challenges and primary care activity. Discussion Telehealth adoption can be influenced by funding, cross-organisational strategic policies and a multi-faceted approach to address clinician reluctance to use telehealth.

Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the Papua Province Indonesian

Background Pandemic infectious diseases cause morbidity and deaths to increase over time globally. Corona virus disease-19 (Covid-19) is an infectious disease found in China in Wuhan City, and spread very quickly to Indonesia and Papua Province. The purpose of this study was to determine limitations of the rural health services, and assessment of the pregnant mothers in the pandemic covid-19 Papua Province of Indonesian. Methods The cross sectional study design, is a type of research to see the relationship between the limitations of rural health services, according to the assessment pregnant mothers in the pandemic covid-19 Papua Province. Jayapura City and Jayapura Regency research sites, which represents all Cities/Regencies in Papua Province. The population is all pregnant mothers in Jayapura City and Jayapura Regency. The samples was 89 pregnant mothers living in rural areas. Data analysis using the Chi-Square test (χ2). Results The limitation of integrated health service post was very less 38,2% and very good 22,5%. The community health center is very less 41,6% and good 22,5%. Hospitals are very less 31,5% and very good 25,8%. The practice of doctors / midwife is less 30,3% and very good 31,5%. The limitations of antenatal care were very less 38,2% and good 22,5%. The limitation treatment of the sick pregnant mothers was 39,3% and good 22,5%. The prevalence covid-19 rural is very high 40,4% and low 20,2%. Assessment of the significant pregnant mothers with prevalence covid-19 of rural, the limitations of integrated health service posts, community health centers, hospitals, doctor/midwife practices, limitations in pregnant mothers, and limitations of treatment for sick pregnant mothers. Conclusion The adverse effects of the pandemic covid-19 are increasing day by day, the provincial government of Papua implements health protocols to protect the public, in other parts of pregnant mothers who don't suffer from corona virus, but suffering from other illnesses and wanting to visit a health service unit is limited.

Attitude towards compulsory rural health services among interns of RajaRajeswari Medical College and Hospital, Bengaluru

Background: In India, majority of Doctors are working in urban than rural areas. Health situation report suggests that medical students should be provided with a rural clinical placement to make them familiar with the rural workplace. Hence the present study was conducted with the aim of assessing the attitude of the interns of RajaRajeswari Medical College and Hospital (RRMCH), Bengaluru, towards compulsory Rural Health Services.Methods: A cross sectional study was conducted at RRMCH, Bengaluru for a period of two months. All the interns willing to participate and present on the day of study were included. Consent was taken and the information was collected by using a self administered semi-structured questionnaire. The participants were asked to respond on a five point Likert scales, ranging from strongly agree to strongly disagree. The data was analyzed using SPSS version 21.0 and Pearson’s chi-square test was applied.Results: Out of 100 interns, majority (56%) was females, 85% were Hindu by religion and 68% were from urban locality. Out of 100 interns, only 14% showed positive attitude towards compulsory rural health services. The reasons for positive attitude were that it provides a good exposure of general practice and an opportunity for independent working.Conclusions: In the present study, only 14% interns showed positive attitude towards rural health services. Perceived factors such as Isolation from family and Inadequate Hospital infrastructure emerged as barrier for the interns to opt for rural services.