The urban-rural divide : hypertensive disease hospitalisations in Victoria 2010–2015
- Robins, Shalley, Gardiner, Samantha, Terry, Daniel
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
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- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
- Full Text:
- Reviewed:
- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
Living in a regional area : access, utilisation and health care quality
- Lê, Quynh, Auckland, Stuart, Nguyên, Hoang, Terry, Daniel, Hoang, Ha
- Authors: Lê, Quynh , Auckland, Stuart , Nguyên, Hoang , Terry, Daniel , Hoang, Ha
- Date: 2013
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2013), p. 20-32
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- Description: Primary health care plays a significant role in the well-being of individuals and communities, yet access to these services can vary. Factors such as socio-economic status and location of residence can impact this access. A study was conducted to investigate the relationship between location, utilisation, quality and health outcomes of primary health care services in the Meander Valley municipality of Tasmania, Australia. This paper reports the findings of the study which adopted a mixed-methods approach with multiple sources of data including government reports, survey questionnaires and interviews. The regional socio-economic disadvantage reflected not only the health disparities and poorer health conditions, but also the affordability to seek care. This was compounded by the lower levels of available health services and private health insurance. The lack of local services or their low quality was the main motivation for many to seek care outside of the region, which was unaffordable and at times logistically impossible. On the basis of the findings, a number of recommendations are provided to guide the current and future health care services and to improve the well-being of the Meander Valley community.
- Authors: Lê, Quynh , Auckland, Stuart , Nguyên, Hoang , Terry, Daniel , Hoang, Ha
- Date: 2013
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2013), p. 20-32
- Full Text:
- Reviewed:
- Description: Primary health care plays a significant role in the well-being of individuals and communities, yet access to these services can vary. Factors such as socio-economic status and location of residence can impact this access. A study was conducted to investigate the relationship between location, utilisation, quality and health outcomes of primary health care services in the Meander Valley municipality of Tasmania, Australia. This paper reports the findings of the study which adopted a mixed-methods approach with multiple sources of data including government reports, survey questionnaires and interviews. The regional socio-economic disadvantage reflected not only the health disparities and poorer health conditions, but also the affordability to seek care. This was compounded by the lower levels of available health services and private health insurance. The lack of local services or their low quality was the main motivation for many to seek care outside of the region, which was unaffordable and at times logistically impossible. On the basis of the findings, a number of recommendations are provided to guide the current and future health care services and to improve the well-being of the Meander Valley community.
The anglo-celtic construction of national identity in Australia and the acculturation of the ‘other’ doctors
- Authors: Terry, Daniel , Lê, Quynh
- Date: 2015
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2015), p. 63 - 76
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- Description: International Medical Graduates (IMG) remain integral to the Australian health workforce, particularly in rural areas. Stakeholders who recruit, support and acts as educators assist IMGs in their transition into and through the Australian health care setting. A study was conducted to examine IMGs and their acculturation in rural Tasmania. Twenty-three IMG stakeholders were interviewed regarding the challenges facing IMGs who live and work in rural Tasmania. Critical Discourse Analysis was used to determine if social power, dominance, and inequality are enacted and reproduced through the text and talk of stakeholders. The results indicate dominant views and practices were both intentionally and unintentionally produced within the Tasmanian health care setting. These issues were reported to be contributing to the marginalisation of IMGs in Tasmania, thus impacting on their retention. However, the participants were positive and respectful in their vocalisation of IMGs and their contribution to the Tasmanian health system and community
- Authors: Terry, Daniel , Lê, Quynh
- Date: 2015
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2015), p. 63 - 76
- Full Text:
- Reviewed:
- Description: International Medical Graduates (IMG) remain integral to the Australian health workforce, particularly in rural areas. Stakeholders who recruit, support and acts as educators assist IMGs in their transition into and through the Australian health care setting. A study was conducted to examine IMGs and their acculturation in rural Tasmania. Twenty-three IMG stakeholders were interviewed regarding the challenges facing IMGs who live and work in rural Tasmania. Critical Discourse Analysis was used to determine if social power, dominance, and inequality are enacted and reproduced through the text and talk of stakeholders. The results indicate dominant views and practices were both intentionally and unintentionally produced within the Tasmanian health care setting. These issues were reported to be contributing to the marginalisation of IMGs in Tasmania, thus impacting on their retention. However, the participants were positive and respectful in their vocalisation of IMGs and their contribution to the Tasmanian health system and community
A descriptive study of health, lifestyle and sociodemographic characteristics and their relationship to known dementia risk factors in rural Victorian communities
- Ervin, Kaye, Pallant, Julie, Terry, Daniel, Bourke, Lisa, Pierce, David, Glenister, Kristen
- Authors: Ervin, Kaye , Pallant, Julie , Terry, Daniel , Bourke, Lisa , Pierce, David , Glenister, Kristen
- Date: 2015
- Type: Text , Journal article
- Relation: Aims Medical Science Vol. 2, no. 3 (2015), p. 246-260
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- Description: It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to determine existing rates of chronic disease, and current lifestyle and sociodemographic factors which may predispose the population to higher risk of dementia. Residents from three shires in rural Victoria, Australia were recruited by random and non-random sampling techniques to complete a survey regarding health perceptions, pre-existing illnesses, health behaviors and social activity in their community. A total of 1474 people completed the survey. Positive factors reported were social participation and low rates of smoking. Negative factors included low rates of physical activity, high rates of obesity and high rates of chronic conditions that indicate significant risk factors for dementia in these communities. Although some factors are modifiable, these communities also have a large population of older residents. This study suggests that community interventions could modify lifestyle risk factors in these rural communities. These lifestyle factors, age of residents and the current chronic conditions are also important for rural service planning to increase preventive actions, and warn of the likely increase in the number of people developing chronic conditions with predispositon to dementia.
- Authors: Ervin, Kaye , Pallant, Julie , Terry, Daniel , Bourke, Lisa , Pierce, David , Glenister, Kristen
- Date: 2015
- Type: Text , Journal article
- Relation: Aims Medical Science Vol. 2, no. 3 (2015), p. 246-260
- Full Text:
- Reviewed:
- Description: It is essential to determine the key health risk factors among populations to specifically plan future services and explore interventions that modify risk factors for communities. This aims to reduce risks and delay the onset of chronic conditions, which frequently results in dementia, particularly for small rural communities which experience health workforce shortages, a higher proportion of those in the chronic conditions age group, and reduced access to care. The aim of the study was to determine existing rates of chronic disease, and current lifestyle and sociodemographic factors which may predispose the population to higher risk of dementia. Residents from three shires in rural Victoria, Australia were recruited by random and non-random sampling techniques to complete a survey regarding health perceptions, pre-existing illnesses, health behaviors and social activity in their community. A total of 1474 people completed the survey. Positive factors reported were social participation and low rates of smoking. Negative factors included low rates of physical activity, high rates of obesity and high rates of chronic conditions that indicate significant risk factors for dementia in these communities. Although some factors are modifiable, these communities also have a large population of older residents. This study suggests that community interventions could modify lifestyle risk factors in these rural communities. These lifestyle factors, age of residents and the current chronic conditions are also important for rural service planning to increase preventive actions, and warn of the likely increase in the number of people developing chronic conditions with predispositon to dementia.
Asthma hospitalisation trends from 2010 to 2015 : variation among rural and metropolitan Australians
- Terry, Daniel, Robins, Shalley, Gardiner, Samantha, Wyett, Ruby, Islam, Md Rafiqul
- Authors: Terry, Daniel , Robins, Shalley , Gardiner, Samantha , Wyett, Ruby , Islam, Md Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 17, no. 1 (2017), p.
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- Description: Background: Asthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993-94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010-2015 results with asthma data prior to 2010. Methods: Hospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables. Results: During the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0-14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0-14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas. Conclusions: We demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient's age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour. © 2017 The Author(s).
Asthma hospitalisation trends from 2010 to 2015 : variation among rural and metropolitan Australians
- Authors: Terry, Daniel , Robins, Shalley , Gardiner, Samantha , Wyett, Ruby , Islam, Md Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Asthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993-94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010-2015 results with asthma data prior to 2010. Methods: Hospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables. Results: During the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0-14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0-14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas. Conclusions: We demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient's age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour. © 2017 The Author(s).
The shortage-surplus paradox : a literature review of primary health care accessibility
- Terry, Melissa, Terry, Daniel, Hoang, Ha, Hannah, Chona
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
- Full Text:
- Reviewed:
- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
- Full Text:
- Reviewed:
- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
Chronic ill health in a regional Victoria setting: A 13-year comparison
- Glenister, Kristen, Bourke, Lisa, Terry, Daniel, Simmons, David
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
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- Reviewed:
- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
- Full Text:
- Reviewed:
- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
The rural nursing workforce hierarchy of needs : decision-making concerning future rural healthcare employment
- Terry, Daniel, Peck, Blake, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
- Full Text:
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- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
- Full Text:
- Reviewed:
- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Understanding childhood injuries in rural areas : using rural acute hospital data register to address previous data deficiencies
- Peck, Blake, Terry, Daniel, Kloot, Kate
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
- Full Text:
- Reviewed:
- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
- Full Text:
- Reviewed:
- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
The socioeconomic characteristics of childhood injuries in regional Victoria, Australia : what the missing data tells us
- Peck, Blake, Terry, Daniel, Kloot, Kate
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 18, no. 13 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Injury is the leading cause of death among those between 1–16 years of age in Australia. Studies have found that injury rates increase with socioeconomic disadvantage. Rural Urgent Care Centres (UCC) represent a key point of entry into the Victorian healthcare system for people living in smaller rural communities, often categorised as lower socio-economic groups. Emergency presentation data from UCCs is not routinely collated in government datasets. This study seeks to compare socioeconomic characteristics of children aged 0–14 attending a UCC to those who attend a 24-h Emergency Departments with an injury-related emergency presentation. This will inform gaps in our current understanding of the links between socioeconomic status and childhood injury in regional Victoria. Methods: A network of rural hospitals in South West Victoria, Australia provide ongoing detailed de-identified emergency presentation data as part of the Rural Acute Hospital Data Register (RAHDaR). Data from nine of these facilities was extracted and analysed for children (aged 0–14 years) with any principal injury-related diagnosis presenting between 1 February 2017 and 31 January 2020. Results: There were 10,137 injury-related emergency presentations of children aged between 0–14 years to a participating hospital. The relationship between socioeconomic status and injury was confirmed, with overall higher rates of child injury presentations from those residing in areas of Disadvantage. A large proportion (74.3%) of the children attending rural UCCs were also Disadvantaged. Contrary to previous research, the rate of injury amongst children from urban areas was significantly higher than their more rural counterparts. Conclusions: Findings support the notion that injury in Victoria differs according to socioeconomic status and suggest that targeted interventions for the reduction of injury should consider socioeconomic as well as geographical differences in the design of their programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 18, no. 13 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Injury is the leading cause of death among those between 1–16 years of age in Australia. Studies have found that injury rates increase with socioeconomic disadvantage. Rural Urgent Care Centres (UCC) represent a key point of entry into the Victorian healthcare system for people living in smaller rural communities, often categorised as lower socio-economic groups. Emergency presentation data from UCCs is not routinely collated in government datasets. This study seeks to compare socioeconomic characteristics of children aged 0–14 attending a UCC to those who attend a 24-h Emergency Departments with an injury-related emergency presentation. This will inform gaps in our current understanding of the links between socioeconomic status and childhood injury in regional Victoria. Methods: A network of rural hospitals in South West Victoria, Australia provide ongoing detailed de-identified emergency presentation data as part of the Rural Acute Hospital Data Register (RAHDaR). Data from nine of these facilities was extracted and analysed for children (aged 0–14 years) with any principal injury-related diagnosis presenting between 1 February 2017 and 31 January 2020. Results: There were 10,137 injury-related emergency presentations of children aged between 0–14 years to a participating hospital. The relationship between socioeconomic status and injury was confirmed, with overall higher rates of child injury presentations from those residing in areas of Disadvantage. A large proportion (74.3%) of the children attending rural UCCs were also Disadvantaged. Contrary to previous research, the rate of injury amongst children from urban areas was significantly higher than their more rural counterparts. Conclusions: Findings support the notion that injury in Victoria differs according to socioeconomic status and suggest that targeted interventions for the reduction of injury should consider socioeconomic as well as geographical differences in the design of their programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Acute circulatory complications in people with diabetes mellitus type 2 : How admission varies between urban and rural Victoria
- Gardiner, Samantha, Robins, Shalley, Terry, Daniel
- Authors: Gardiner, Samantha , Robins, Shalley , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 1 (2019), p. 49-56
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- Description: Objective: To identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus. Design: Retrospective study. Setting: All Victorian hospitals. Participants: State-wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases. Main outcome measure: Rates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables. Results: In total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas. Conclusion: Victorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.
- Authors: Gardiner, Samantha , Robins, Shalley , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 1 (2019), p. 49-56
- Full Text:
- Reviewed:
- Description: Objective: To identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus. Design: Retrospective study. Setting: All Victorian hospitals. Participants: State-wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases. Main outcome measure: Rates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables. Results: In total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas. Conclusion: Victorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.
- Terry, Daniel, Peck, Blake, Kloot, Kloot, Hutchins, Toinette
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kloot , Hutchins, Toinette
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Asthma Vol. 59, no. 2 (2022), p. 264-272
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- Description: Objectives: Australia has one of the highest prevalence of asthma globally, and accessible emergency asthma presentation data remains vital, however, is currently underreported in regional and rural areas. Utilizing the Rural Acute Hospital Data Register (RAHDaR) which includes previously non-reported data, the aim of the study is to provide a more accurate understanding of asthma emergency presentation events, while investigating the factors associated with these presentations. Methods: A retrospective cross-sectional study collected de-identified emergency asthma presentation data from nine health services in regional Victoria for children aged 0 to 14 years between 2017 and 2020. Demographic and presentation data were collated along with government datasets. Asthma emergency presentations incidence rates and predictor variables were analyzed using hierarchical multiple regression after adjusting for smoking and sex. Significance was determined at p < 0.05. Results: Of the 1090 emergency asthma presentations, n = 369 occurred at health services who did not previously report data. This represents a 33.86% increase in our understanding of emergency asthma presentations and demonstrating a rate of 16.06 presentations per 1000 children per year. Key factors such as age, population density, and private health insurance were associated with asthma emergency presentation events among both sexes, while socioeconomic status and rurality were not predictive. Conclusions: Although some findings are consistent with current research, the study highlights previously unrecognized specific factors that are predictive of asthma among 0–14-year-old children. These findings provide more accurate insights for healthcare workers and policymakers as they seek to support people with asthma and accurately address health inequities. © 2020 Taylor & Francis Group, LLC.
Perspectives of aboriginal issues among non-aboriginal residents of rural Victorian communities
- Bourke, Lisa, Malatzky, Christina, Terry, Daniel, Nixon, Raelene, Ferguson, Karyn, Ferguson, Peter
- Authors: Bourke, Lisa , Malatzky, Christina , Terry, Daniel , Nixon, Raelene , Ferguson, Karyn , Ferguson, Peter
- Date: 2017
- Type: Text , Journal article
- Relation: Australian Journal of Social Issues Vol. 52, no. 3 (2017), p. 278-293
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- Description: Racism, in various forms, remains a dominant feature in Australian society. Aboriginal Australians are commonly targets of racial discrimination. However, understanding racism is difficult given that racial attitudes vary towards particular groups of people, across place and time and are difficult to measure. This paper presents responses of residents across four rural shires in Victoria to questions about attitudes towards Aboriginal people/issues. Responses indicated that attitudes towards Aboriginal people were diverse and that individuals varied in their attitudes on specific items. There were subtle differences between the four sites and association between demographic characteristics and some items in particular sites. This suggests that respondents are inconsistent in their attitudes relating to Aboriginal people/issues and that there are place-based influences on these attitudes. We conclude that the many varied understandings of racism and Aboriginal Australians allow the discourses of exclusion, disempowerment and othering to be maintained. © 2017 Australian Social Policy Association.
- Authors: Bourke, Lisa , Malatzky, Christina , Terry, Daniel , Nixon, Raelene , Ferguson, Karyn , Ferguson, Peter
- Date: 2017
- Type: Text , Journal article
- Relation: Australian Journal of Social Issues Vol. 52, no. 3 (2017), p. 278-293
- Full Text:
- Reviewed:
- Description: Racism, in various forms, remains a dominant feature in Australian society. Aboriginal Australians are commonly targets of racial discrimination. However, understanding racism is difficult given that racial attitudes vary towards particular groups of people, across place and time and are difficult to measure. This paper presents responses of residents across four rural shires in Victoria to questions about attitudes towards Aboriginal people/issues. Responses indicated that attitudes towards Aboriginal people were diverse and that individuals varied in their attitudes on specific items. There were subtle differences between the four sites and association between demographic characteristics and some items in particular sites. This suggests that respondents are inconsistent in their attitudes relating to Aboriginal people/issues and that there are place-based influences on these attitudes. We conclude that the many varied understandings of racism and Aboriginal Australians allow the discourses of exclusion, disempowerment and othering to be maintained. © 2017 Australian Social Policy Association.
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