Rural emergency care facilities may be adapting to their context: A population-level study of resources and workforce.

Abstract

ObjectiveTo provide a structured understanding of rural hospital‐based emergency care facility workforce and resources.DesignThe resources of regional training hubs were used to survey eligible emergency care facilities in their surrounding region.SettingRural emergency care facilities manage more than one third of Australia's emergency presentations. These emergency care facilities include emergency departments and less‐resourced facilities in smaller towns.ParticipantsHospital facilities located outside metropolitan areas that report emergency presentations to the Australian Institute of Health and Welfare.InterventionsA survey tool was sent by email.Main outcome measuresPresence of human, diagnostic and other resources as reported on a questionnaire.ResultsA completed questionnaire was received from 195 emergency care facilities. Over 60% of Small hospitals had on‐call doctors only. General practitioners/generalists and nurses with extended emergency skills were found in all hospital types. Emergency physicians were present across all remoteness areas, but more commonly seen in larger facilities. All Major/Large facilities and most Medium facilities reported having onsite pathology and radiology. Point of care testing and clinician radiography were more commonly reported in smaller facilities. Among Small hospitals, Very Remote hospitals were more likely than Inner Regional hospitals to have an onsite doctor in the emergency care facility and/or a high dependency unit.ConclusionSmaller and more remote facilities appear to adapt by using different workforce structures and bedside investigations.