Regional Australia Research Articles

Measuring for primary prevention: An online survey of local community perspectives on family and domestic violence in regional Australia.

Family and domestic violence, encompassing diverse behaviours including physical, sexual, emotional and financial abuse, is endemic worldwide and has multiple adverse health and social consequences. Principal drivers include traditional gender values that disempower women. Changing these is a key prevention strategy. In Australia, high-quality national surveys provide data on public perspectives concerning family and domestic violence but may not capture community-level diversity. As part of a project for primary prevention family and domestic violence in outer regional Australia, our aims were to develop and administer a questionnaire-based survey suitable for the local community encompassing knowledge about, attitudes towards, and personal experiences of family and domestic violence, to describe and to investigate the theoretical (factor) structure and local socio-demographic predictors of responses, and to determine the extent to which the survey findings are locally distinctive. The online community survey for local residents (≥15 years), comprised items on respondents' sociodemographic characteristics plus questions abridged from pre-existing national instruments on knowledge about, attitudes towards, and personal experiences of family and domestic violence. Responses were rake-weighted to correct census-ascertained sample imbalance and investigated using exploratory factor analysis, with sociodemographic predictors determined using multiple linear regression and dominance analysis. Among 914 respondents, males (27.0%), those from age-group extremes, and less-educated persons were underrepresented. Familiarity with diverse family and domestic violence behaviours was high among all subgroups. Poorer knowledge of the FDV behaviour continuum and attitudes supporting traditional gender roles and FDV were disproportionately evident among males, older respondents and those with lower education levels. Both the factor structure of extracted composite measures reflecting community perspectives and sociodemographic predictors of responses generally aligned with patterns evident in national data. Local reinforcement of existing nationwide findings on community understanding of and attitudes towards family and domestic violence provides salience for targeted interventions.

Modelling accessibility of adult neurology care in Australia, 2020–2034

IntroductionIn 2015/2016, annual national expenditure on neurological conditions exceeded $A3 billion. However, a comprehensive study of the Australian neurological workforce and supply/demand dynamics has not previously been undertaken.MethodsCurrent neurological workforce...

MP02-08 CATHETER ASSOCIATED MUCOSAL PRESSURE INJURIES (CAMPI): A NOVEL STUDY DEFINING THE IMPACT OF LONG TERM URETHRAL CATHETERS

You have accessJournal of UrologyCME1 Apr 2023MP02-08 CATHETER ASSOCIATED MUCOSAL PRESSURE INJURIES (CAMPI): A NOVEL STUDY DEFINING THE IMPACT OF LONG TERM URETHRAL CATHETERS Kandice Keogh, Devang Desai, and Hannah Flynn Kandice KeoghKandice Keogh More articles by this author , Devang DesaiDevang Desai More articles by this author , and Hannah FlynnHannah Flynn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003213.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Indwelling urethral catheters (IDC) are common in surgical practice. Given their widespread use, it is tempting to dismiss IDCs as benign drainage tubes. However, a significant complication is erosion of the urethra and surrounding soft tissues resulting in a pressure injury. We coined the term Catheter-Associated Mucosal Pressure Injury (CAMPI) for this form of iatrogenic hypospadias. Active treatment for CAMPI can be invasive with significant side effect profiles, emphasizing the importance of prevention in these patients. To date, there has been little research into CAMPI. Existing publications are either isolated case reportsor small case series. This study explored the prevalence and risk factors of CAMPI in adults with long-term IDCs in regional Australia. METHODS: A multi-centre cross-sectional study was undertaken at two large regional hospitals. The cohort was comprised of 200 adults with an IDC in-situ for >4 weeks between January 2019 to June 2021. Data was collected via a voluntary questionnaire and review of medical records. A novel grading system based on existing hypospadias classification was developed (Image 1). RESULTS: Overall prevalence of CAMPI was 9% (17/200). The mean IDC duration in patients with CAMPI was 39 weeks (9.7 months). The shortest time between IDC insertion and CAMPI detection was only 2 weeks. Prevalence was higher in males (16/169, 10%) compared to females (1/31, 3%). In males, the grades of CAMPI were meatal (7/17, 41%), glanular (3/17, 18%), coronal (4/17, 23%), subcoronal (1/17, 6%), distal penile shaft (1/17, 6%) and mid-penile shaft (1/17, 6%). The female case involved erosion of the urethral orifice during a long hospital admission. Over two-thirds of adults with a CAMPI had an IDC >16Fr (13/18, 72%). Latex IDCs were more common than silicone IDCs in both groups (78% non-CAMPI vs 67% CAMPI, p=0.49). Poor mobility (36% non-CAMPI vs 72% CAMPI, p=0.01), community managed IDCs (26% non-CAMPI vs 50% CAMPI, p=0.03), and congestive cardiac failure (9% non-CAMPI vs 28% CAMPI, p=0.02) were associated with CAMPI formation. CONCLUSIONS: CAMPI is a prevalent complication of long-term IDCs and prevention is key. Catheter securement, hygiene and care must be prioritised by all clinicians who insert, manage and change IDCs. Source of Funding: Nil Funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e13 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kandice Keogh More articles by this author Devang Desai More articles by this author Hannah Flynn More articles by this author Expand All Advertisement PDF downloadLoading ...

What have the Romans ever done for us?

The only privilege of being the Editor in Chief of a journal is that I get the opportunity to write an editorial for every edition. I can say, within reason, what I like, without peer review, censor or editing by anyone else. This being my last editorial for the journal that is probably even more true. So, as I sat contemplating the blank screen to write this editorial, my tongue decided it was once again time to explore the tooth that was causing me some discomfort, where a chip had come off making it extremely sensitive. My experience of managing this dental problem brought my mind to the RHMT funding for rural health workforce training and that is when the title of this paper came to the front of my mind. Yes, for those of you from my generation, I am referencing the classic scene from Monty Python's, Life of Brian. As John Cleese, playing the part of Reg goes on to say “apart from sanitation, the medicine, education, wine, public order, irrigation, roads, a fresh water system and public health, what have the Romans ever done for us?” What has that got to with the Australian rural health care. Well at times I feel like I am Reg in the Life of Brian. I struggle to see what the Romans, in the form of the RHMT funded Rural Clinical Schools, University Departments of Rural Health and Dental Training Expanding Rural Placement Programs have done for us. If I go back to my tooth. I live in a regional city, Bendigo, with both a Rural Clinical School (Monash), a University Department of Rural Health (La Trobe University) and a Dental School, solely based in Bendigo. Yet, when I saw the dentist and it was determined that I need my tooth assessed for suitability of a crown (it might need root canal work), my options were to wait a long time for an appointment with the Endodontist who comes to Bendigo from Melbourne, or travel to Melbourne to see them at their practice. In the latter case, I could get an appointment within a week, in the former, more than a month wait with ongoing pain. So, despite all the RHMT funding and rural health workforce training here in Bendigo, if I wanted a reasonably quick resolution of my tooth pain, I needed to go to Melbourne. Fortunately, I have the advantage of a good income and flexible employment, which allowed me to do that, with no financial penalty. Unfortunately, the vast majority of our rural communities do not have that privilege. So, at an individual level, I feel like Reg. Apart from “on average, graduates who had the most rural clinical placement experience are now working more in regional, rural and remote Australia” (1 p213) and “the RHMT program, has a direct economic benefit to the communities and regions with economic analyses demonstrating a positive multiplier effect of around 2 i.e. for every spent under the RHMT program another dollar is generated in the local economy” (1 p 236), I wonder what has the RHMT programme done for us. Despite these assertions, we do not have any good quality evidence anywhere that the approach we are taking is actually addressing the problems of recruiting and retaining a rural and remote health workforce. Where are the data that the workforce shortage in a city or town is less after an RCS or UDRH was established than before, or that towns without RCS's and UDRHs have more workforce shortages and worse health outcomes than communities with them. In the most recent review, that I am aware of,2 identified that 34 papers focused on health workforce retention interventions for rural and remote areas. They conclude that most of the studies were of low quality, that about only one-third applied appropriate statistical analysis to the date, less than half adjusted for key potential confounders, and many had no comparator groups.2 In no other contexts of health care would that be considered a solid literature base to make any conclusions on, yet it does not deter the authors from asserting “Policy makers seeking rural retention in the medium and longer term would be prudent to strengthen rural training pathways and limit the use of strongly coercive interventions.”2 So, my plea to the few people who read these editorials is can we please stop pretending that the RHMT programme has had a major impact on the health and health workforce of rural and remote Australia and spent the time and intellectual effort to actually determine if this approach is working because I am not seeing what the RHMT programme has done for my tooth.

Migrant and Refugee Retention in Regional Australia at the Intersection of Structure and Agency

This article examines the question of migrant and refugee retention in small and medium-sized towns referred to as ‘regional towns’ in Australia as a problem at the intersection of structure and agency in migration and settlement processes. Regional settlement pathways typically occur in the context of business interests in a reliable labour supply, government efforts of migration management and, importantly, migrants’ and refugees’ socially embedded life courses that are shaped by aspirations, opportunities and constraints. Rather than reducing the question of retention to one of migrant and refugee choice, this article explores the question whether people with migration backgrounds remain in regional locations through the conceptual lens of structuration and situated learning. Based on an analysis of key policies that have shaped regional migration and settlement in Australia and an analysis of qualitative interviews with migrants in different visa categories in regional Victoria, conducted over the last ten years, the article will explore three key factors influencing retention: migration policies, employment experiences in the context of settlement and migrants and refugees’ situated knowledge emerging from these experiences over time. In conclusion, I will argue that unpacking the policy quandary of migrant and refugee retention sociologically can contribute to advancing both an understanding of mobility and immobility as integral to migration processes and the development of sustainable regional migration policies.

Hypocenter, Fault Plane, and Rupture Characterization of Australian Earthquakes: Application to the September 2021 Mw 5.9 Woods Point Earthquake

AbstractThe Australian Seismometers in Schools (AuSIS) network operates 50 broadband seismic stations across Australia that are hosted at schools. The instruments augment the Australian National Seismograph Network providing valuable data from urban and regional Australia. The network coverage is quite sparse, but these vital records of rare, moderate Australian earthquakes can improve our understanding of the deformation within the stable continental region of Australia, especially for events with no surface rupture. In this study, we present the feasibility of identifying the fault plane of moderate earthquakes on the Australian continent, using data from the AuSIS network. We examine the fault plane of the September 2021 Mw 5.9 Woods Point earthquake that occurred about 130 km northeast of the Melbourne metropolitan area. We estimate the hypocenter and the centroid moment tensor (CMT) to identify the fault plane from the auxiliary plane in the focal mechanism. We explore a range of 1D models and a 3D Earth model to simulate seismic arrivals and full waveform data. The hypocenter is resolved using P- and S-wave arrivals in a probabilistic framework and the CMT is derived from full waveform modeling through grid search over a set of trial points around the hypocenter. Our solution suggests the mainshock ruptured the depth of 15 ± 4 km, with a strike-slip mechanism striking 348° north on a nearly vertical plane. The high double-couple percentage of this event indicates a simple rupture that propagated from the south (hypocenter) toward the north (centroid) and remained subsurface. This indicates that the causative fault had a deeper structure than the previously known shallow, northwest–southeast-striking faults of the region. The P and T axes deduced from our fault model are notably aligned with the maximum horizontal crustal stress in the region.

Effect of Psychosocial, Behavioral, and Disease Characteristics on Health-Related Quality of Life (HRQoL) After Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population.

Increasing long-term breast cancer survivorship has highlighted the importance of patient-reported outcomes such as health-related quality of life (HRQoL) in addition to traditional outcomes that were used to define successful operative management. This study aimed to describe HRQoL in patients who underwent breast cancer resection in a regional Australian setting and identify the psychosocial, demographic, and operative characteristics associated with poor HRQoL. Consecutive patients who underwent breast cancer resection between 2015 and 2022 were included. Patients were asked to complete a survey instrument that included validated measures of HRQoL, emotional distress, fear of cancer recurrence (FCR), and social support. Demographic, disease, and operative data were collected from the medical record of the respondents. Forty-six patients completed the survey (100% female, mean age = 62.68 years). Most HRQoL domains were significantly lower than an Australian reference population. HRQoL was more strongly associated with psychosocial factors (emotional distress, FCR, and social support) but was also associated with socioeconomic status, stage of cancer at presentation, and surgical complications. HRQoL was not related to breast conservation, management of the Axilla, or time since operation. Long-term changes in HRQoL should be considered during the management and surveillance of breast cancer patients in regional Australia.

Beyond the 'big smoke': Enabling supervision of ophthalmology trainees in regional, rural and remote Australia.

Expansion of opportunities for ophthalmology training beyond the 'big smoke' is anticipated to support the future distribution of ophthalmologists in regional, rural and remote areas of Australia. However, little is known about what enables supervision outside of metropolitan tertiary hospital settings that would contribute to positive training experiences for specialist medical trainees and encourage them to leave the 'big smoke' once qualified. The aim of this study was therefore to explore the perceived enablers of ophthalmology trainee supervision in regional, rural and remote health settings across Australia. Australia. Ophthalmologists working in regional, rural or remote health settings with experience and/or interest in supervising ophthalmology trainees (n= 16). Qualitative design involving semistructured interviews. Seven key enablers of ophthalmology trainee supervision in regional, rural and remote health settings were identified: adequate physical infrastructure, resources and funding to host a trainee; availability of online curriculum and teaching resources so as to ensure equity of training opportunities; pre-established training posts, driven by supervision 'champions'; a critical mass of ophthalmologists to help share the supervisory load; relationships and support between training posts, the training network and the Specialist Medical College; alignment of trainee competence and attitude with the needs of the training setting; and the recognition of reciprocal benefits for supervisors through supporting trainees, including workforce support and renewal. With training experiences beyond the 'big smoke' anticipated to influence future ophthalmology workforce distribution, implementation of enablers of trainee supervision should occur in regional, rural and remote health settings wherever possible.

The Role of Universities in Strengthening Regional Arts Sectors: Central Queensland University and the Regional Arts Services Network

Noting the unique challenges facing arts and culture in rural and regional Australia, this article takes the Central Queensland Regional Arts Services Network (CQRASN) as a case study to examine the role of universities in supporting the regional arts sector. Previous research acknowledges the contributions of universities to the arts sector through evaluation, innovation and knowledge transfer. This case study enables exploration of a different model of university and arts sector interaction. This article discusses the role and limitations of CQRASN in managing a regional cultural network and outlines future considerations for universities in strengthening the regional arts sector.

Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth (ORIENT): a protocol for a stepped-wedge pragmatic cluster-randomised controlled trial in Australian general practice

IntroductionWomen living in rural and regional Australia often experience difficulties in accessing long-acting reversible contraception (LARC) and medical abortion services. Nurse-led models of care can improve access to these services...

The ethics of being an editor–researcher

Although only a few months old at press time, ChatGPT has already established itself as one of the biggest disruptors of historical conceptions of authorship, reality and trust. The research community will no doubt face increasing challenges as it attempts to deal with peer review, conflicts-of-interest and publishing ethics. Readers may know that the International Journal of Community Music is a Committee on Publication Ethics (COPE) member. COPE establishes ethical guidelines for the academic publishing. No doubt these will evolve in the face of emerging artificial intelligence technology. The existing guidelines are helpful but still leave many issues unaddressed, such as what researchers should do when it comes to publishing in a journal they edit. In addition to Kathleen Turner’s autoethnographic reflective essay about the challenges arising from the COVID-19 crisis on a university-based community music training programme and Anna McMichael’s study of composer/musicians involved with the annual classical Tyalgum Music Festival in regional Australia, Issue 16:1 features three articles authored or co-authored by the journal’s editors, who devised an in-house system to ensure the integrity of the double-blind peer review system. The issue concludes with a dedication to Janice Waldron (1957–2022), who passed away suddenly and unexpectedly in November 2022.

Activating a music festival: Extending musical practices by composing with communities

This article explores the motivations, approaches and results that occurred when six composers/musicians devised works of experimental music that involved community participants over six years at the annual classical Tyalgum Music Festival in regional Australia. The main aim of this study was to investigate how this music was shaped by community participation in its creation and performance. This qualitative research study drew on retrospective interviews with the musicians involved and the author’s observations and reflections on their music events. The musicians discussed how they responded to people and place in creating and performing their works; they maintained that their involvement with the community resulted in valuable and creative music-making. This study demonstrates that artists can inspire interesting and enjoyable music-making with a community that also expands the possibilities for mainstream arts, cultural practices and festival curation.

The production of precariousness and the racialisation of Pacific Islanders in an Australian horticultural region

ABSTRACT Over the last ten years, temporary migration schemes in the horticultural sector have received increasing attention in the Global North. The often precarious conditions of such work have been recognised, however, little attention has been paid to horticultural workers with migration backgrounds who have gained permanent residency or citizenship in the host countries. Ethnographic fieldwork with Pacific farmworkers and their families with various migration statuses in Australia, including seasonal workers, irregular migrants, and permanent residents, revealed that precarious employment conditions in horticultural work impact Pacific people across and beyond different legal statuses, challenging the notion of a clear correlation between irregularity and precariousness. This includes the children of migrants with Australian citizenship who are often employed as casual farmworkers and find it difficult to secure any other work. We argue that their experiences are fundamentally related to their position as ‘racialised’ workers. This paper sheds light on this racialisation of farmwork and its implications for the experiences of Pacific people as residents and workers in regional Australia.

‘You Are Up Against It Down Here’. Providing Domestic and Family Violence Services in Regional Australia

Problems associated with recognising and reporting domestic and family violence (DFV) have been well established. Challenges around DFV service provision have been addressed by considering particular types of place, typically metropolitan or rural and remote areas. This article examines DFV services from the perspective of service providers in a regional area around 100 kilometres south of Sydney. In this context, DFV service providers reflected on the barriers and challenges of providing services to two target communities: challenges that were representative of nationwide service experiences but exacerbated by specific regional characteristics. Their experiences suggest that competitive, short-term and innovation-focused funding streams have contributed to a siloed service landscape that clients struggle to navigate. Greater attention to service integration would address many of these challenges.

Using a modified Delphi method to identify research priorities in an Australian regional health service

ABSTRACT Background Health service providers need to set their own research priorities to ensure investment of limited resources into projects relevant to their setting. Rural health services may face additional challenges in identifying research priorities if they comprise a research-naeïve workforce. This study examines the methods employed by one health service to identify research priorities across a multidisciplinary health service in regional Australia. Method A modified 3-round Delphi method was employed, with panellists from clinical divisions, management, and consumer groups. Modifications included delivery via etechnology; inclusion of a reference group; a large panel who were selected without prior consultation; provision for non-sequential engagement in rounds by panellists; and group level feedback between rounds. Results In total 270 panellists were enlisted from across the health service, representing all levels of management, clinicians with and without research experience, and consumers. Valid research priorities for the whole of service were successfully identified using the modified Delphi method. Conclusion This study demonstrates how a regional health service with minimal research experience, was able to utilise a modified Delphi methodology to facilitate research priority setting across a widespread and multidisciplinary health service. Modifications to the Delphi methodology and their utility within the research setting are discussed.

Use of General Practitioner Telehealth Services During the COVID-19 Pandemic in Regional Victoria, Australia: Retrospective Analysis.

In March 2020, the Australian Government expanded general practitioner (GP) telehealth services in response to the COVID-19 pandemic. This study sought to assess use patterns of GP telehealth services in response to changing circumstances (before and during the COVID-19 pandemic and with or without a lockdown) in regional Victoria, Australia. We conducted a secondary analysis of monthly Medicare claims data from July 2019 to June 2021 from 140 regional GP practices in Western Victoria. The longitudinal patterns of proportion of GP telehealth consultations stratified by type of consultation (ie, videoconference vs telephone) and by geographical, consumer, and consultation characteristics were analyzed. Telehealth comprised 25.8% (522,932/2,025,615) of GP consultations over the 2-year period. After the introduction of the Australian telehealth expansion policy in March 2020, there was a rapid uptake in GP telehealth services (including telephone and video services), from 0% before COVID-19 to 15% (11,854/80,922) of all consultations in March 2020, peaking at 55% (50,828/92,139) in August 2020. Thereafter, the use of telehealth declined steadily to 31% (23,941/77,344) in January 2021 and tapered off to 28% (29,263/103,798) in June 2021. Telephone services and shorter consultations were the most dominant form, and those aged 15-64 years had higher telehealth use rates than younger or older age groups. The proportion of video consultations was higher during periods with government-imposed lockdowns and higher in the most socioeconomically advantaged areas compared to less socioeconomically advantaged areas. Our findings support the continuation of telehealth use in rural and regional Australia post pandemic. Future policy must identify mechanisms to reduce existing equity gaps in video consultations and consider patient- and system-level implications of the dominant use of short telephone consultations.

Hyperlipidaemia and Weight Amongst Afghani Refugees Attending a General Practice Clinic in Regional Australia

Obesity and chronic disease are increasing problems in refugee populations. Afghani refugees undergoing hepatitis B vaccination between January 2015 and December 2017 at a general practice clinic received dietary counselling sessions in Dari by native speaking clinicians. Anthropometry, blood pressure, fasting lipids and liver function tests were measured at both visits with results compared over time. 110/119 refugees requiring hepatitis B vaccination were recruited into the study. Mean BMI was lower at follow up visits (25.4 vs 26.1 by wilcoxon signed rank test p 0.04) with 72 of 110 participants losing a median of 2 kg between visits (range 0.5–14 kg) a mean of 206 days after the initial consultation. Median triglyceride levels were lower at the second visit than the first (1.4 vs 1.3 mmol/L Wilcoxon signed rank test Z = 3.5, p 0.0004). This cohort of refugees lost weight and showed a small improvement in triglyceride levels between visits.

Practising care in a pandemic: Accounting for everyday life during COVID-19 among people who inject drugs.

From the outset of the COVID-19 pandemic, fears have been raised worldwide regarding the unique challenges facing socially marginalised people such as those who inject drugs. This article draws on in-depth interviews conducted during the first year of the pandemic with people who inject drugs living in urban and regional Australia. Perhaps the most surprising finding to emerge was the number of participants who reported minimal disruption to their everyday lives, even improved wellbeing in some instances. Attempting to make sense of this unanticipated finding, our analysis draws on the concept of 'care', not as a moral disposition or normative code but as something emergent, contingent and realised in practice. Working with Foucault's ethics and recent feminist insights on the politics of care from the field of Science and Technology Studies, we explore how care was enacted in the everyday lives of our participants. We examine how participants' daily routines became objects of care and changed practice in response to the pandemic; how their ongoing engagement with harm reduction services afforded not only clinical support but vital forms of social and affective connection; and how for some, care was realised through an ethos and practice of constrained sociality and solitude.

Acceptability of a virtual prostate cancer survivorship care model in regional Australia: A qualitative exploratory study.

To assess the acceptability of a nurse-led prostate cancer survivorship intervention adapted for virtual delivery and tailored to post-surgical care, in a regional Australian hospital and health service. A qualitative exploratory study using the Theoretical Framework of Acceptability (TFA). Twenty-two participants took part in a semistructured interview comprising men who had completed the program (n=16) and health professionals/service stakeholders involved in program delivery (n=6). Acceptability of this virtual prostate cancer survivorship care program was very high across all constructs of the TFA, from the perspectives of both program recipients and those delivering the program. The quality of care received was seen as superior to what men had experienced previously (burden, opportunity costs). The time afforded by the regularly scheduled video-consultations allowed men to come to terms with the recovery process in theirown time (self-efficacy), and provided an ongoing sense of support and access tocareoutside the consultation (ethicality). Clinically, the program improved careco-ordination, expedited identification of survivorship care needs, and met servicepriorities of providing quality care close to home (burden, perceived effectiveness). Findings from this study suggest virtual post-surgical care delivered via videoconferencing is highly acceptable to prostate cancer survivors in a regional setting. Future research exploring virtual program implementation at scale and long-term patient and service outcomes is warranted.

TIME TO SURGERY FOR ELDERLY HIP FRACTURES: A RETROSPECTIVE COMPARATIVE REVIEW OF DIRECT ADMISSIONS VERSUS PERIPHERAL HOSPITAL TRANSFER

Current recommendations advocate for surgery within 48 hours from time of injury as a keystone in care for elderly patients with hip fractures. A spare population density within regional Australia provides physical challenges to meet time critical care parameters. This study aims to review the impact of delays to timely surgery for elderly hip fracture patients within a regional Australian population.A retrospective, comparative analysis was undertaken of 140 consecutive hip fracture patients managed at a single rural referral hospital, from June 2020 until June 2021. Factors such as age, time to transfer, time to surgery, 30-day complication and 6-month complication rates were collected. Statistical analysis was performed where applicable.Mean time to surgery was 33.9 hours. A greater proportion of patients whom directly presented underwent surgery within the recommended 48 hours (91.5% vs 75.3%). The statistically significant delay in time to surgery was found to be 6.4 hours. Lower 180-day morbidity and mortality rates were observed in patients undergoing surgery within 48 hours (13.8% vs 36%), This is in comparison to the overall mortality rate of 19.2%.Delay to surgery for elderly hip fracture patients was associated with an increase 30-day and 180-day morbidity and mortality rate. A greater proportion of patients transferred from peripheral hospitals experienced a delay in surgery. Early transfer and prioritization of such patients is recommended to achieve comparative outcomes for rural and remote Australians.