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Internal medicine in the bush: a clinical audit of a rural and remote outreach programme
Author(s) -
Foy A.,
Tierney A.
Publication year - 2014
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12372
Subject(s) - medicine , outreach , indigenous , service (business) , audit , family medicine , demographics , demography , economy , management , sociology , political science , law , economics , biology , ecology
Background Provision of internal medicine services in rural A ustralia is always problematic. Aim The aim was to undertake an audit of an outreach service operating in N orthern N ew S outh W ales since 2006. Methods The service is conducted eight times a year, involving a consultant and an advanced trainee who travel by car to the towns of M oree and M ungindi and conduct clinics in a general practice setting, an A boriginal medical service and a local health district clinic. Since 2008, a cardiology service and a diabetes service have been added on a fly‐in fly‐out basis. Case records of all patients enrolled in the service between February 2006 and July 2013 were reviewed in determining the demographics, clinical presentations and level of service coverage. The experience of the authors in establishing the service provided insights into the challenges and the success factors involved. Results Five hundred and eighty‐three patients were seen on a total of 1070 occasions relating to a wide variety of clinical presentations. Of these, 31.3% were indigenous compared with 20% in the local statistical area, and both indigenous and non‐indigenous patients were seen in all settings. Patients fell into 15 different diagnostic categories with indigenous patients more likely to present for diabetes ( P < 0.001) and hepatitis B ( P < 0.01), but less likely to present for treatment of hepatitis C ( P < 0.01). Conclusions In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.