Inequalities in rural health care: differences in surgical intervention between metropolitan and rural Western Australia

ANZ J Surg. 2005 May;75(5):265-9. doi: 10.1111/j.1445-2197.2005.03375.x.

Abstract

Background: To compare surgical procedure rates between metropolitan and rural/remote residents in Western Australia (WA).

Methods: The WA Data Linkage System was used to identify all patients who underwent a procedure for cataract, ureteric calculi or urinary outflow obstruction symptoms for the time periods 1981-2000, 1981-1997 and 1981-1995, respectively. Age-standardized procedure rates were calculated and Poisson regression modelling was used to estimate effects of locality of residence and demographic covariates.

Results: Overall, rural/remote patients underwent first-time procedures for cataract (IRR 0.92; 95% CI 0.90-0.94), ureteric calculi (0.76; 0.72-0.80), or urinary outflow obstruction (0.71; 0.69-0.74) less frequently than patients in the metropolitan area. They were also significantly less likely to undergo multiple procedures for cataracts (0.90; 0.88-0.91) and ureteric calculi (0.69; 0.67-0.73).

Conclusion: A distinctly reduced level of surgical intervention was found in rural patients for three generally non-life threatening conditions. The reasons for this require further investigation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cataract Extraction / statistics & numerical data*
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Medical Record Linkage
  • Middle Aged
  • Poisson Distribution
  • Rural Health Services / statistics & numerical data*
  • Rural Population / statistics & numerical data
  • Transurethral Resection of Prostate / statistics & numerical data*
  • Urban Population / statistics & numerical data
  • Urinary Calculi / surgery*
  • Western Australia