Evidence-based initiatives to improve rural health

  • Community Paramedics involved in primary health care to address the needs of rural communities.

Community Paramedics involved in primary health care to address the needs of rural communities.
[Image: Professor Gina Agarwal, McMaster University]

Prof Leigh Kinsman,
Assoc Prof Evelien Spelten,
Dr Fiona Dangerfield,
Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School;
Dr Ruth Hardman,
Sunraysia Community Health Services;
Prof Gina Agarwal,
Department of Family Medicine, McMaster University, Canada

The unacceptable disparity in health outcomes and access to health services between rural and urban Australians is a complex issue. Many people living in rural and remote communities have limited or no access to general practitioners and other health professionals. The Violet Vines Marshman Centre for Rural Health Research (VVMCRHR) is committed to improving equity and access for rural people by partnering with communities and consumers. Two innovative and evidence-based initiatives pivotal to the Centre’s activities are the investigation of the Community Paramedicine model and the Rural Health Consumer Panel.

Primary health services that are inaccessible for the most disadvantaged, and the subsequent poor management of chronic disease, are known contributors to frequent and non-urgent use of ambulance services and emergency departments. We also know that there are many trained paramedics not able to get jobs with ambulance services. Gina Agarwal (McMaster University, Canada) has led extensive research demonstrating that the Community Paramedic role, within the Community Paramedicine at Clinic program or CP@clinic – which combines assessment, referral, education and communication – improves the health of individuals and the efficiency of the health system. Evelien Spelten (VVMCRHR), Sunraysia Community Health Services in Victoria and McMaster University are supporting a local implementation trial of CP@clinic to understand how the role can make a difference in the rural Australian context.

This innovative strategy to retain the health workforce in rural and regional areas facilitates the expansion of paramedic roles to work directly with the community to assess and support health needs and operate outside the traditional emergency call-out role. To take the next important step in understanding how Community Paramedics can make a difference in rural and regional communities, VVMCRHR is partnering in further research with community health services, Ambulance Victoria, Murray Primary Health Network, Victorian Healthcare Association, McMaster University, Victoria University and Monash University. This model represents an innovative use of an available workforce to respond to the local contexts of diverse rural and regional communities facing challenges in attracting and retaining health professionals. 

The Rural Health Consumer Panel was launched last year. A key objective of this initiative is to engage rural health consumers systematically and sustainably in identifying research priorities and approaches beneficial to the health of rural Australians. The Rural Health Consumer Panel project facilitates a meaningful, practical and relevant collaboration between consumers, rural health services, academic institutions and industry partners.

The panel allows rural people to be front and centre of research initiatives to overcome the unacceptable disparities they face when trying to access health care. This initiative puts real-time lived experience and wisdom of service users in the driver’s seat, guiding where and how our research can make a difference. The panel was developed in close collaboration with NIVEL Health Care Research in the Netherlands, who have a strong consumer panel that has been going for over 30 years, with around 12,000 members. We aim to have 1,500 rural consumers on our panel within five years.

VVMCRHR is committed to innovative, evidence-based approaches and will continue to partner with consumers, rural health services and communities to produce targeted workforce solutions and better health outcomes for rural people.

For more information on these and other activities, please visit www.latrobe.edu.au/research/violetmarshman

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