Rationing is a reality in rural physiotherapy: A qualitative exploration of service level decision-making

BMC Health Services Research

Volumn 15, Issue 1, 2015, Pages

  Adams, Robyn ^a   Jones, Anne ^a   Lefmann, Sophie ^b   Sheppard, Lorraine ^a,b  

^a JAMES COOK UNIVERSITY   (Australia)

^b UNIVERSITY OF SOUTH AUSTRALIA   (Australia)

Author keywords

Decision making; Health Services; Physiotherapy; Prioritization; Rationing; Regional; Rural

Indexed keywords

ADULT; AUSTRALIA; COMPARATIVE STUDY; DECISION MAKING; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE ORGANIZATION; HUMAN; MALE; MIDDLE AGED; PHYSIOTHERAPY; QUESTIONNAIRE; RURAL HEALTH CARE; RURAL POPULATION; STATISTICS AND NUMERICAL DATA; URBAN POPULATION;

ADULT; AUSTRALIA; DECISION MAKING; DELIVERY OF HEALTH CARE; FEMALE; HEALTH CARE RATIONING; HEALTH SERVICES ACCESSIBILITY; HUMANS; MALE; MIDDLE AGED; PHYSICAL THERAPY MODALITIES; RURAL HEALTH SERVICES; RURAL POPULATION; SURVEYS AND QUESTIONNAIRES; URBAN POPULATION;

EID: 84961290199     PISSN: None     EISSN: 14726963     Source Type: Journal    
DOI: 10.1186/s12913-015-0786-3     Document Type: Article

References (52)

1. Wilson NW, Couper ID, De Vries E, Reid S, Fish T, Marais BJ. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health. 2009;9(2):1060. PubMed English.
2. Schindeler S, Moore M, Eckstein G, Turner R, Kaldor J, Cerny M, et al. Rural health information project: Rural health classifications systems. SHP (EPI) 060127 NSW Rural Institute for Clinical Services and Teaching, Centre for Epidemiology and Research, Population Health Division. Sydney, NSW: Department of Health; 2006. p. 6-20.
3. Australian Institute of Health and Welfare (AIHW). Remoteness classifications. Canberra. 2015 (cited 30 March 2015). Available from http://www.aihw.gov.au/rural-health-remoteness-classifications/.
4. Australian Bureau of Statistics (ABS). Where do they live? Australian Social Trends April 2013 Canberra. 2013 [cited 2014 20 April]. http://www.abs.gov.au/AUSSTATS/abs.nsf/Lookup/4102.0Main+Features30April+2013.
5. Australian Institute of Health and Welfare (AIHW). Allied health workforce 2012. National health workforce series no. 5. HWL 51. Canberra: Australian Institute of Health and Welfare; 2013.
6. Australian Institute of Health and Welfare (AIHW). Australia's Health. Canberra: AIHW; 2008.
7. Carey TA, Wakerman J, Humphreys JS, Buykx P, Lindeman M. What primary health care services should residents of rural and remote Australia be able to access? Systematic Rev BMC Health Serv Res. 2013;13(1):178.
8. Humphreys JS. Key considerations in delivering appropriate and accessible health care for rural and remote populations: discussant overview. Aust J Rural Health. 2009;17(1):34-8.
9. Wakerman J, Humphreys JS, Wells R, Kuipers P, Entwistle P, Jones J. Primary health care delivery models in rural and remote Australia-a systematic review. BMC Health Serv Res. 2008;8(1):276.
10. Martin D, Singer P. A strategy to improve priority setting in health care institutions. Health Care Anal. 2003;11(1):59-68.
11. Sibbald SL, Singer PA, Upshur R, Martin DK. Priority setting: what constitutes success? A conceptual framework for successful priority setting. BMC Health Services Research. 2009;9(43):1. Epub 2009 March 5.
12. Arvidsson E, André M, Borgquist L, Carlsson P. Priority setting in primary health care-dilemmas and opportunities: a focus group study. BMC Fam Pract. 2010;11(1):71.
13. Barasa EW, Molyneux S, English M, Cleary S. Setting healthcare priorities in hospitals: a review of empirical studies. Health policy and planning. 2014;(3):1-11.
14. Putoto G, Pegoraro R. Resource allocation in health care. In: Rudnick A, editor. Bioethics in the 21st century. Rijeka, Croatia: In Tech; 2011.
15. Australian Physiotherapy Association (APA). The Factors affecting the supply of health services and medical professionals in rural areas: Submission to Senate Community Affairs Committee. Melbourne: APA; 2011.
16. Sheppard L. Work practices of rural and remote physiotherapists. Aust J Rural Health. 2001;9(2):84-90. PubMed English.
17. Higgs J, Refshauge K, Ellis E. Portrait of the physiotherapy profession. J Interprof Care. 2001;15(1):79-89. PubMed English.
18. Williams E, D'Amore W, McMeeken J. Physiotherapy in rural and regional Australia. Aust J Rural Health. 2007;15(6):380-6.
19. Struber J. Physiotherapy in Australia-where to now? The Internet Journal of Allied Health Sciences and Practice. 2003;1(2):2.
20. Lindsay R, Hanson L, Taylor M, McBurney H. Workplace stressors experienced by physiotherapists working in regional public hospitals. Aust J Rural Health. 2008;16(4):194-200. PubMed English.
21. Edwards I, Jones M, Carr J, Braunack-Mayer A, Jensen GM. Clinical reasoning strategies in physical therapy. Phys Ther. 2004;84(4):312-30. discussion 31-5. PubMed English.
22. Edwards I, Braunack-Mayer A, Jones M. Ethical reasoning as a clinical-reasoning strategy in physiotherapy. Physiotherapy. 2005;91(4):229-36.
23. Edwards I, Richardson B. Clinical reasoning and population health: decision making for an emerging paradigm of health care. Physiother. 2008;24(3):183-93. PubMed.
24. Finch E, Geddes EL, Larin H. Ethically-based clinical decision-making in physical therapy: process and issues. Physiother. 2005;21(3):147-62. PubMed English.
25. Grimmer-Somers K. Incorporating research evidence into clinical practice decisions. Physiother Res Int. 2007;12(2):55-8. PubMed English.
26. Smith M, Higgs J, Ellis E. Physiotherapy decision making in acute cardiorespiratory care is influenced by factors related to the physiotherapist and the nature and context of the decision: a qualitative study. Australian J Physiotherapy. 2007;53(4):261.
27. Smith M, Higgs J, Ellis E. Characteristics and processes of physiotherapy clinical decision making: a study of acute care cardiorespiratory physiotherapy. Physiother Res Int. 2008;13(4):209-22. PubMed English.
28. Smart K, Doody C, Smart K, Doody C. The clinical reasoning of pain by experienced musculoskeletal physiotherapists. Man Ther. 2007;12(1):40-9. PubMed English.
29. Brown AM, Pirotta M. Determining priority of access to physiotherapy at Victorian community health services. Aust Health Rev. 2011;35(2):178-84. PubMed Language: English. Entry Date: 20110812. Revision Date: 20120127. Publication Type: journal article.
30. Miller-Mifflin TM, Bzdell M. Development of a physiotherapy prioritization tool in the Baffin region of Nunavut: a remote, under-serviced area in the Canadian arctic. Rural Remote Health. 2010;10(2):1466. PubMed Language: English. Entry Date: 20100910. Revision Date: 20100910. Publication Type: journal article.
31. Christie HJ. Feature articles-physiotherapy caseload guidelines. Physiother Can. 1999;51(3):186-90.
32. Simmons NC, Kuys SS. Trial of an allied health workload allocation model. Aust Health Rev. 2011;35(2):168-75.
33. Schoo AM, Boyce RA, Ridoutt L, Santos T. Workload capacity measures for estimating allied health staffing requirements. Aust Health Rev. 2008;32(3):548-58.
34. Scott A, Cheng MT. Workload Measures for Allied Health Professionals. Final Report. Adelaide: National Health Workforce Planning and Research Collaboration; 2010.
35. Kapiriri L, Norheim OF, Martin DK. Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making? Soc Sci Med. 2009;68(4):766-73.
36. Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso-and macro-levels in Canada. Norway and Uganda. Health Policy. 2007;82(1):78-94.
37. Mechanic D. Muddling through elegantly: finding the proper balance in rationing. Health Aff. 1997;16(5):83-92.
38. Ham C, Coulter A. Explicit and implicit rationing: taking responsibility and avoiding blame for health care choices. J Health Serv Res Policy. 2001;6:164.
39. Smith M, Higgs J, Ellis E. Factors influencing clinical decision making. In: Higgs J, editor. Clinical reasoning in the health professions. Amsterdam: Elsevier Health Sciences; 2008. p. 89-100.
40. National Health and Hospitals Reform Commission,(NHHRC). Beyond the blame game. Accountability and performance benchmarks for the next Australian health care agreements. Canberra: National Health and Hospitals Reform Commission; 2008.
41. Liamputtong P, Ezzy D. Qualitative research methods. Second edition ed. Melbourne: Oxford University Press; 2005.
42. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage Publications; 2002.
43. National Rural Health Alliance (NRHA). Under pressure and undervalued: allied health professionals in rural and remote Australia. Canberra: National Rural Health Alliance; 2004. October 2004. Report No.
44. Anaf S, Drummond C, Sheppard L. Combining case study and systems theory as a heuristic model. Qual Health Res. 2007;17(10):1309-15.
45. Grbich C. Qualitative research in health: an introduction. St Leonards, N.S.W: Allen & Unwin; 1999.
46. Bailey DM. Research for the health professional: a practical guide. Second edition ed. Philadelphia: F.A. Davis Company; 1997.
47. Baxter P, Jack S. Qualitative case study methodology: study design and implementation for novice researchers. Qual Rep. 2008;13(4):544-59.
48. Higgs J, Refshauge K, Ellis E. Profiles of the professions. Portrait Physiotherapy Profession J Interprof Care. 2001;15(1):79-89.
49. Fitzgerald K, Hornsby D, Hudson L. A study of allied health professionals in rural and remote Australia. Canberra: Services for Australian Rural and Remote Allied Health SARRAH; 2001.
50. Campbell N, McAllister L, Eley D. The influence of motivation in recruitment and retention of rural and remote allied health professionals: a literature review. Rural Remote Health. 2012;12:1900. Epub 2012.
51. Miles E, Adams R, Anaf S, Sheppard L. Factors identified by physiotherapists that influence retention of regional clinicians: A qualitative investigation. 2010 Jan. Internet J Allied Health Sci Practice. 2010;8(1):1.
52. Roots RK, Li LC. Recruitment and retention of occupational therapists and physiotherapists in rural regions: a meta-synthesis. BMC Health Serv Res. 2013;13(1):59.