Rural chronic disease research patterns in the United Kingdom, United States, Canada, Australia and New Zealand: a systematic integrative review
Tóm tắt
People living in rural and remote communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. The aim of this paper was to describe the characteristics and outcomes of studies investigating innovative models of care for people living with chronic disease in rural areas of developed countries where a metropolitan comparator was included. An integrative systematic review was undertaken. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to understand the empirical and theoretical data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom. Literature searching revealed 620 articles published in English between 1st January 2000 and 31st March 2019. One hundred sixty were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations. This integrated review reveals that the published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease.
Tài liệu tham khảo
Eberhardt MS, Ingram DD, Makuc DM, et al. Urban and Rural Health Chartbook. Health, United States, 2001. Hyattsville: National Centre for Health Statistics; 2001.
Australian Institute of Health and Welfare, Rural, Regional and Remote Health: a study on mortality (summary of findings). 2003. Canberra, Australia. AIHW Cat.no. PHE 49 (Rural Health Series no 3).
Mansfield CJ, Wilson JL, Kobrinski EJ, et al. Premature mortality in the United States: the role of geographic area, socioeconomic status, household type, and availability of medical care. Am J Public Health. 1999;89(6):893–8.
Clarke RA, Eckert KA, Stewart S, et al. Rural and urban differentials in primary care management of chronic heart failure: new data from the CASE study. Med J Aust. 2007;186(9):441–5.
Ansari MZ, Henderson T, Ackland M, et al. Congestive cardiac failure: urban and rural perspectives in Victoria. Aust J Rural Health. 2003;11(6):266–70.
Lawlor DA, Bedford C, Taylor M, et al. Geographical variation in cardiovascular disease, risk factors, and their control in older women: British Women’s heart and health study. J Epidemiol Community Health. 2003;57(2):134–40.
Andrus MR, Kelley KW, Murphey LM, et al. A comparison of diabetes care in rural and urban medical clinics in Alabama. J Community Health. 2004;29(1):29–44.
Simmons D, McKenzie A, Eaton S, et al. Prevalence of diabetes in rural Victoria. Diabetes Res Clin Pract. 2005;70(3):287–90.
Croft JB, Wheaton AG, Liu Y, et al. Urban-Rural County and state differences in chronic obstructive pulmonary disease – United States 2015. Morb Mortal Wkly Rep. 2018;67(7):205–11.
Ansari Z, Dunt D, Dharmage SC. Variations in hospitalizations for chronic obstructive pulmonary disease in rural and urban Victoria, Australia. Respirology. 2007;12(6):874–80.
Rucker D, Hemmelgarn BR, Lin MC, et al. Quality of care and mortality are worse in chronic kidney disease patients living in remote areas. Kidney Int. 2011;79(2):210–7.
Thompson S, Gill J, Wang X, et al. Higher mortality among remote compared to rural or urban dwelling haemodialysis patients in the United States. Kidney Int. 2012;82(3):352–9.
Hart LG, Lawson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health. 2005;95(7):1149–55.
Centre for Disease Control and Prevention. Leading health indicators at a glance. https://www.cdc.gov/nchs/healthy_people/hp2020/hp2020_indicators.htm Accessed 15 Nov 2019.
Kulshreshtha A, Goyal A, Dabhadkar K, et al. Urban-rural differences in coronary heart disease mortality in the United States: 1999-2009. Public Health Rep. 2014;129(1):19–29.
Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States. Findings from NHANES (2005-2008). J Rural Health. 2012;28(4):392–7.
O’Connor A, Wellenius G. Rural-urban disparities in the prevalence of diabetes and coronary heart disease. Public Health. 2012;126(10):813–20.
United States Department of Health and Human Services. With understanding and improving health and objectives for improving health. 2 volumes. Washington DC: Government Printing Offices; 2010.
Glenister K, Disler R, Hulme A, et al. The mosaic of general practice bulk billing in regional Victoria. Aust J Gen Pract. 2019;48(1–2):77–8.
Sibley LM, Weiner JP. An evaluation of access to health care services along the rural-urban continuum in Canada. BMC Health Serv Res. 2011;11:20.
Azzopardi P, Brown AD, Zimmet P, et al. Type 2 diabetes in young indigenous Australians in rural and remote areas: diagnosis, screening, management and prevention. Med J Aust. 2012;197(1):32–6.