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The distribution of maternity services across rural and remote Australia: does it reflect population need?

Overview of attention for article published in BMC Health Services Research, February 2017
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Title
The distribution of maternity services across rural and remote Australia: does it reflect population need?
Published in
BMC Health Services Research, February 2017
DOI 10.1186/s12913-017-2084-8
Pubmed ID
Authors

Margaret I Rolfe, Deborah Anne Donoghue, Jo M Longman, Jennifer Pilcher, Sue Kildea, Sue Kruske, Jude Kornelsen, Stefan Grzybowski, Lesley Barclay, Geoffrey Gerard Morgan

Abstract

Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need. Health facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility. Catchment exclusions: metropolitan areas, populations above 25,000 or below 1,000, and a non-birthing facility within the catchment of one with birthing. Catchments were attributed with population-based characteristics representing need: population size, births, demographic factors, socio-economic status, and a proxy for isolation - the time to the nearest facility providing a caesarean section (C-section). Facilities were dichotomised by service level - those providing birthing services (birthing) or not (no birthing). Birthing services were then divided by C-section provision (C-section vs no C-section birthing). Analysis used two-stage univariable and multivariable logistic regression. There were 259 health facilities identified after exclusions. Comparing services with birthing to no birthing, a population is more likely to have a birthing service if they have more births, (adjusted Odds Ratio (aOR): 1.50 for every 10 births, 95% Confidence Interval (CI) [1.33-1.69]), and a service offering C-sections 1 to 2 h drive away (aOR: 28.7, 95% CI [5.59-148]). Comparing the birthing services categorised by C-section vs no C-section, the likelihood of a facility having a C-section was again positively associated with increasing catchment births and with travel time to another service offering C-sections. Both models demonstrated significant associations with jurisdiction but not socio-economic status. Our investigation of current birthing services in rural and remote Australia identified disparities in their distribution. Population factors relating to vulnerability and isolation did not increase the likelihood of a local birthing facility, and very remote communities were less likely to have any service. In addition, services are influenced by jurisdictions.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 95 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 95 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 17 18%
Student > Master 12 13%
Researcher 10 11%
Student > Ph. D. Student 8 8%
Student > Doctoral Student 6 6%
Other 15 16%
Unknown 27 28%
Readers by discipline Count As %
Medicine and Dentistry 19 20%
Nursing and Health Professions 16 17%
Social Sciences 10 11%
Unspecified 3 3%
Biochemistry, Genetics and Molecular Biology 2 2%
Other 14 15%
Unknown 31 33%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2019.
All research outputs
#14,334,250
of 24,468,058 outputs
Outputs from BMC Health Services Research
#4,896
of 8,267 outputs
Outputs of similar age
#162,873
of 315,619 outputs
Outputs of similar age from BMC Health Services Research
#99
of 165 outputs
Altmetric has tracked 24,468,058 research outputs across all sources so far. This one is in the 40th percentile – i.e., 40% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,267 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 315,619 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 165 others from the same source and published within six weeks on either side of this one. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.