EXPERIENCE IN THE DEVELOPMENT OF RURAL MEDICINE IN DEVELOPED COUNTRIES: A LITERARY REVIEW
Introduction. According to the State Program for the Development of Healthcare of the Republic of Kazakhstan for 2020-2025, the provision of doctors in cities is 56.8 per 10 thousand of the population, and 16.1 per 10 thousand of the population in rural areas. Eighty-three percent of all doctors in the country work in urban areas and only 17% in rural areas. The problem of the provision of human resources remains relevant and not fully resolved. To this end, we have conducted a literature review of the available sources to better understand how this problem is being addressed in other countries of the world.
The aim of the research is to study the experience of the development of rural medicine in the developed countries of the world.
Search strategy. We studied publicly available articles over 30 years using the following databases of scientific publications and specialized search engines: PubMed, Google Scholar, Cochrane Library, Web of Science, Scopus. Information search was carried out by keywords: rural medicine, telemedicine, COVID-19.
Inclusion criteria: Publication level of evidence A, B: meta-analyzes, systematic reviews, cohort and cross-sectional studies.
Exclusion criteria: expert opinion in the form of short messages, promotional articles.
Results. Analysis of international and domestic experience in the development of rural medicine notes a shortage of personnel, including family doctors in rural areas. Mentoring and organization of the educational process in the workplace play an important role in the professional development of a rural specialist. Proper organization of primary health care with elements of distance medicine reduces health care costs and improves public health indicators.
Conclusion. In the era of digitalization, the development of family medicine in rural areas can receive an additional impetus due to the use of modern technologies, which should be provided to every medical institution in the countryside.
Bagym S. Jobalayeva1, https://orcid.org/0000-0002-2145-2263
Dariga S. Smailova2 http://orcid.org/0000-0002-7152-7104
Yuliya M. Semenova1, https://orcid.org/0000-0003-1324-7806
1 NJSC «Semey Medical University», Semey city, Republic of Kazakhstan;
2 Kazakhstan’s Medical University «Kazakhstan School of Public Health», Almaty, Republic of Kazakhstan.
1. Adunlin G., Murphy P.Z., Manis M. COVID-19: How Can Rural Community Pharmacies Respond to the Outbreak? J Rural Heal. 2021;37(1):153-155. doi:10.1111/jrh.12439.
2. Alavi M., Ho T., Stisher C., et al. Factors that influence student choice in family medicine: A national focus group. Fam Med. 2019;51(2):143-148. doi:10.22454/FamMed.2019.927833.
3. Angaran D.M. Telemedicine and telepharmacy: Current status and future implications. Am J Heal Pharm. 1999;56(14):1405-1426. doi:10.1093/ajhp/56.14.1405.
4. Arvier P.T., Walker J.H., McDonagh T. Training emergency medicine doctors for rural and regional Australia: can we learn from other countries? Rural Remote Health. 2007;7(2):705. doi:10.22605/rrh705.
5. Bang F,. McFaull S., Cheesman J., Do M.T. The rural–urban gap: Differences in injury characteristics. Heal Promot Chronic Dis Prev Canada. 2019;39(12):317-322. doi:10.24095/hpcdp.39.12.01.
6. Batsis J.A., DiMilia P.R., Seo L.M., et al. Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review. J Am Geriatr Soc. 2019;67(8):1737-1749. doi:10.1111/jgs.15959.
7. Batsis J.A., Pletcher S.N., Stahl J.E. Telemedicine and primary care obesity management in rural areas - Innovative approach for older adults? BMC Geriatr. 2017;17(1). doi:10.1186/s12877-016-0396-x.
8. Blattner K., Stokes T., Nixon G. A scope of practice that works ‘out here’: Exploring the effects of a changing medical regulatory environment on a rural New Zealand health service. Rural Remote Health. 2019;19(4). doi:10.22605/RRH5442.
9. Bly J. What is medicine? Recruiting high-school students into family medicine. Can Fam Physician. 2006;52(MAR.):329-334. /pmc/articles/PMC1479711/. Accessed April 29, 2021.
10. Bowman M.A., Neale A.V., Seehusen D.A. The potpourri of family medicine, in sickness and in health. J Am Board Fam Med. 2018;31(4):495-498. doi:10.3122/jabfm.2018.04.180136.
11. Brian Collins, Tyrone F Borders, Kristen Tebrink KTX. Utilization of prescription medications and ancillary pharmacy services among rural elders in west Texas: distance barriers and implications for telepharmacy - PubMed. J Heal Hum Serv Adm. 2007;30(1):75-97. https://pubmed.ncbi.nlm.nih.gov/17557697/. Accessed February 22, 2021.
12. Bunge P. A model for internal medicine physicians in a small rural hospital. Rural Remote Health. 2018;18(3). doi:10.22605/RRH4419.
13. Bynum A., Hopkins D., Thomas A., Copeland N., Irwin C. The effect of telepharmacy counseling on metered-dose inhaler technique among adolescents with asthma in rural Arkansas. Telemed J e-Health. 2001;7(3):207-217. doi:10.1089/153056201316970902.
14. Carriere R., Adam R., Fielding S., Barlas R., Ong Y., Rural dwellers are less likely to survive cancer – An international review and meta-analysis. Heal Place. 2018;53:219-227. doi:10.1016/j.healthplace.2018.08.010.
15. Colegrove D.J., Whitacre B.E. Interest in rural medicine among osteopathic residents and medical students. Rural Remote Health. 2009;9(3):1192.
16. Combi C., Pozzani G., Pozzi G. Telemedicine for developing countries: A survey and some design issues. Appl Clin Inform. 2016;7(4):1025-1050. doi:10.4338/ACI-2016-06-R-0089.
17. Dowell J., Norbury M., Steven K., Guthrie B. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: Survey of GP origins and current place of work Career choice, professional education and development. BMC Med Educ. 2015;15(1). doi:10.1186/s12909-015-0445-8.
18. Evans Y.N., Golub S., Sequeira G.M., Eisenstein E., North S. Using Telemedicine to Reach Adolescents During the COVID-19 Pandemic. J Adolesc Heal. 2020;67(4):469-471. doi:10.1016/j.jadohealth.2020.07.015.
19. Gerard W.A. Pawn and King play: A stalemate on rural emergency medicine staffing. J Am Board Fam Med. 2019;32(3):292-294. doi:10.3122/jabfm.2019.03.190077.
20. Goodridge D, Marciniuk D. Rural and remote care. Chron Respir Dis. 2016;13(2):192-203. doi:10.1177/1479972316633414.
21. Harriet Denz-Penhey. JCM. A student view of the difference between general practice and rural and remote medicine - PubMed. Rural Remote Heal. 2007;7(2):641. https://pubmed.ncbi.nlm.nih.gov/17477793/. Accessed February 25, 2021.
22. Hesse B.W. Role of the internet in solving the last mile problem in medicine. J Med Internet Res. 2019;21(10). doi:10.2196/16385.
23. Hirko K.A., Kerver J.M., Ford S., et al. Telehealth in response to the COVID-19 pandemic: Implications for rural health disparities. J Am Med Informatics Assoc. 2020;27(11):1816-1818. doi:10.1093/jamia/ocaa156.
24. Loftus J., Allen E.M., Call K.T, Everson-Rose S.A. Rural-Urban Differences in Access to Preventive Health Care Among Publicly Insured Minnesotans. J Rural Heal. 2018;34 (Suppl 1):s48-s55. doi:10.1111/jrh.12235.
25. Nissen L., Tett S. Can telepharmacy provide pharmacy services in the bush? J Telemed Telecare. 2003;9 Suppl 2. doi:10.1258/135763303322596228.
26. Nixon G., Blattner K., Williamson M., McHugh P., Reid J. Training generalist doctors for rural practice in New Zealand. Rural Remote Health. 2017;17(1). doi:10.22605/rrh4047.
27. O’Hara V.M., Johnston S.V., Browne N.T. The paediatric weight management office visit via telemedicine: pre- to post-COVID-19 pandemic. Pediatr Obes. 2020;15(8). doi:10.1111/ijpo.12694.
28. O’Sullivan B., Russell D., McGrail M., et al. Factors related to rural general practitioners supervising general practice registrars in Australia a national cross-sectional study. Aust J Gen Pract. 2019;48(1-2). doi:10.31128/AJGP-07-18-4637.
29. O’Toole R.F., Wright J. Growing the pool of rural general practitioners. Rural Remote Health. 2020;20(4):5769. doi:10.22605/RRH5769.
30. Ohannessian R., Duong T.A., Odone A. Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: A call to action. JMIR Public Heal Surveill. 2020;6(2). doi:10.2196/18810.
31. Park B., Gold S.B., Bazemore A., Liaw W. How evolving United States payment models influence primary care and its impact on the quadruple aim. J Am Board Fam Med. 2018;31(4):588-604. doi:10.3122/jabfm.2018.04.170388.
32. Rabinowitz H.K., Diamond J.J., Markham F.W. Santana A.J. Retention of rural family physicians after 20-25 years: Outcomes of a comprehensive medical school rural program. J Am Board Fam Med. 2013;26(1):24-27. doi:10.3122/jabfm.2013.01.120122.
33. Sanchez E.J. Toward optimal and equitable rural health. Am J Public Health. 2020;110(9):1340-1341. doi:10.2105/AJPH.2020.305856.
34. Sanchez E.J. Toward optimal and equitable rural health. Am J Public Health. 2020;110(9):1340-1341. doi:10.2105/AJPH.2020.305856.
35. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K., Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018;24(1):4-12. doi:10.1177/1357633X16674087.
36. Shayakhmetov S.S., Toguzbayeva K.K., Ismailova A.A., Tabibi R., Derbishalieva Z.K., Dzhusupov K.O. Health literacy of rural population of Kazakhstan. Iran J Public Health. 2020;49(7):1269-1277. doi:10.18502/ijph.v49i7.3580.
37. Stutzman K., Karpen R.R., Naidoo P., et al. Support for rural practice: Female physicians and the life-career interface. Rural Remote Health. 2020;20(1). doi:10.22605/RRH5341.
38. Yong J., Scott A., Gravelle H., Sivey P., McGrail M. Do rural incentives payments affect entries and exits of general practitioners? Soc Sci Med. 2018;214:197-205. doi:10.1016/j.socscimed.2018.08.014.
39. Espenbetova M.Zh. i dr. Podgotovka vrachei obshchei praktiki - osnovnoe napravlenie povysheniya kachestva i effektivnosti sistemy okhrany zdorov'ya naseleniya [Training of general practitioners is the main direction of improving the quality and efficiency of the public health care system]. Nauka i zdravookhranenie [Science & Healthcare]. 2013. № 4. pp. 8–10. [in Russian]
40. Musina D.S. i dr. Puti uluchsheniya kachestva i povysheniya ekonomicheskoi effektivnosti Natsional'noi skriningovoi programmy na rannee vyyavlenie onkologicheskikh zabolevanii (na primere Pavlodarskoi oblasti). Protokol issledovaniya [Ways of improving the quality and enhancing the economic efficiency of national screening program for the early detection of oncological diseases (for example, Pavlodar region). Study protocol]. Nauka i zdravookhranenie [Science & Healthcare]. 2017. № 1. pp. 97–111. [in Russian]
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Jobalayeva B.S., Smailova D.S., Semenova Yu.M. Experience in the development of rural medicine in developed countries: a literary review // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 3, pp. 31-50. doi:10.34689/SH.2021.23.3.004Related publications:
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