Abstract
Are we there yet?' Distance to definitive care for Irish patients in the Better Data, Better Planning (BDBP) study
Part of Special Series: WONCA World Rural Health Conference Abstracts 2022
AUTHORS
Niamh Cummins1 Lecturer In Public Health *
Louise Barry2 Specialist Research Nurse
Carrie Garavan3 Teacher, Lecturer, Researcher
Collette Devlin4 Research Nurse
Gillian Corey5 Specialist Research Nurse
Fergal Cummins6 Consultant in Emergency Medicine and Retrieval Medicine
Damien Ryan7 Supervisor
Sinead Cronin8 GP, Clinical Lecturer
Emma Wallace9 Professor, Head of Department
Gerry McCarthy10 Consultant in Emergency Medicine
Rose Galvin11 Senior Lecturer in Physiotherapy
CORRESPONDENCE
*Dr Niamh Cummins
AFFILIATIONS
1 School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland; and Health Research Institute, University of Limerick, Limerick, Ireland
2, 4, 11 School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, University of Limerick, Limerick, Ireland; and Health Research Institute, University of Limerick, Limerick, Ireland
3 Health Research Institute, University of Limerick, Limerick, Ireland; and School of Nursing & Midwifery, University of Limerick, Limerick, Ireland
5 Health Research Institute, University of Limerick, Limerick, Ireland; and ALERT Limerick EM Education Research Training, Emergency Department, University Hospital Limerick, Limerick, Ireland
6, 7 School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland; and ALERT Limerick EM Education Research Training, Emergency Department, University Hospital Limerick, Limerick, Ireland
8, 9 Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
10 Emergency Department, Cork University Hospital, Cork, Ireland
PUBLISHED
10 January 2023 Volume 23 Issue 1
HISTORY
RECEIVED: 20 September 2022
ACCEPTED: 20 September 2022
CITATION
Cummins N, Barry L, Garavan C, Devlin C, Corey G, Cummins F, Ryan D, Cronin S, Wallace E, McCarthy G, Galvin R. Are we there yet?' Distance to definitive care for Irish patients in the Better Data, Better Planning (BDBP) study. Rural and Remote Health 2023; 23: 8168. https://doi.org/10.22605/RRH8168
AUTHOR CONTRIBUTIONS
This work is licensed under a Creative Commons Attribution 4.0 International Licence
abstract:
Background: Residing long distances from definitive care compromises patient safety and, in rural Ireland, travel distance to health care can be substantial, particularly in light of national General Practitioner (GP) shortages and hospital reconfigurations. The aim of this research is to describe the profile of patients attending Irish Emergency Departments (EDs) in terms of distance from GP care and definitive care in the ED.
Method: The 'Better Data, Better Planning' (BDBP) census was a multi-centre, cross-sectional study of n=5 urban and rural EDs in Ireland throughout 2020. At each site, all adults presenting over a 24-h census period were eligible for inclusion. Data were collected on demographics, healthcare utilisation, service awareness and factors influencing the decision to attend the ED, with analysis in SPSS.
Results: For n=306 participants, median distance to a GP was 3 km (range 1–100 km) and median distance to the ED was 15 km (range 1–160km). Most participants (n=167, 58%) lived within 5 km of their GP and within 10 km of the ED (n=114, 38%). However, 8% of patients lived ≥15 km from their GP and 9% of patients lived ≥50 km from their nearest ED. Patients living >50 km from the ED were more likely to be transported by Ambulance (p<0.05).
Conclusions: Proximity to health services, by geographical location, is poorer in rural regions, so it’s important that these patients have equity of access to definitive care. Therefore, expansion of alternative care pathways in the community and additional resourcing of the National Ambulance Service with enhanced aeromedical support is essential in the future.
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