The impacts of withdrawal and replacement of general practitioner services on aeromedical service trends: A 13-year interrupted time-series study in Tennant Creek, Northern Territory

Matthew Haren, John Setchell, David John, Mark DANIEL

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Abstract

Background
The Royal Flying Doctor Service (RFDS) provides aeromedical care to patients during fixed-wing transport over vast distances to healthcare unavailable in rural or remote communities. This study examined the relationship between changes in local accessibility to primary healthcare services and rates of aeromedical service use over time.

Methods
This was a 13-year interrupted time-series study (1999–2012) in Tennant Creek, Northern Territory. Quarterly aeromedical service use for primary care sensitive conditions were calculated and exposure to general practice (GP) services was characterised over time with events modelled as intervention variables: (a) GP service withdrawal (Nov-2004); and (b) GP service replacement (Dec-2006). Intervention effects were estimated using PROC ARIMA in SAS after examination of the time-series structure.

Results
GP withdrawal resulted in an immediate and sustained doubling in quarterly aeromedical service use (+11.8 services per quarter) and GP service replacement had no significant effect.

Discussion
Large and immediate increases in aeromedical service use result from the loss of local GPservices yet, in this case, replacement with a new GP service, 2-years hence, did not ameliorate that effect after six years.

Conclusions
These findings demonstrate the immediate impact of GP-service loss on the rates ofaeromedical transfer of patients from this remote community and lend caution to expectations about thetimeline over which newly implemented primary health care services in such contexts can mitigate the impact of such a loss
Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalBMC Health Services Research
Volume15
Issue number1
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Northern Territory
General Practice
General Practitioners
Primary Health Care
Patient Transfer
Health Services
Interrupted Time Series Analysis
Patient Care
Delivery of Health Care

Cite this

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title = "The impacts of withdrawal and replacement of general practitioner services on aeromedical service trends: A 13-year interrupted time-series study in Tennant Creek, Northern Territory",
abstract = "BackgroundThe Royal Flying Doctor Service (RFDS) provides aeromedical care to patients during fixed-wing transport over vast distances to healthcare unavailable in rural or remote communities. This study examined the relationship between changes in local accessibility to primary healthcare services and rates of aeromedical service use over time.MethodsThis was a 13-year interrupted time-series study (1999–2012) in Tennant Creek, Northern Territory. Quarterly aeromedical service use for primary care sensitive conditions were calculated and exposure to general practice (GP) services was characterised over time with events modelled as intervention variables: (a) GP service withdrawal (Nov-2004); and (b) GP service replacement (Dec-2006). Intervention effects were estimated using PROC ARIMA in SAS after examination of the time-series structure.ResultsGP withdrawal resulted in an immediate and sustained doubling in quarterly aeromedical service use (+11.8 services per quarter) and GP service replacement had no significant effect.DiscussionLarge and immediate increases in aeromedical service use result from the loss of local GPservices yet, in this case, replacement with a new GP service, 2-years hence, did not ameliorate that effect after six years.ConclusionsThese findings demonstrate the immediate impact of GP-service loss on the rates ofaeromedical transfer of patients from this remote community and lend caution to expectations about thetimeline over which newly implemented primary health care services in such contexts can mitigate the impact of such a loss",
author = "Matthew Haren and John Setchell and David John and Mark DANIEL",
year = "2015",
doi = "10.1186/s12913-015-1110-y",
language = "English",
volume = "15",
pages = "1--7",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BioMed Central",
number = "1",

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TY - JOUR

T1 - The impacts of withdrawal and replacement of general practitioner services on aeromedical service trends: A 13-year interrupted time-series study in Tennant Creek, Northern Territory

AU - Haren, Matthew

AU - Setchell, John

AU - John, David

AU - DANIEL, Mark

PY - 2015

Y1 - 2015

N2 - BackgroundThe Royal Flying Doctor Service (RFDS) provides aeromedical care to patients during fixed-wing transport over vast distances to healthcare unavailable in rural or remote communities. This study examined the relationship between changes in local accessibility to primary healthcare services and rates of aeromedical service use over time.MethodsThis was a 13-year interrupted time-series study (1999–2012) in Tennant Creek, Northern Territory. Quarterly aeromedical service use for primary care sensitive conditions were calculated and exposure to general practice (GP) services was characterised over time with events modelled as intervention variables: (a) GP service withdrawal (Nov-2004); and (b) GP service replacement (Dec-2006). Intervention effects were estimated using PROC ARIMA in SAS after examination of the time-series structure.ResultsGP withdrawal resulted in an immediate and sustained doubling in quarterly aeromedical service use (+11.8 services per quarter) and GP service replacement had no significant effect.DiscussionLarge and immediate increases in aeromedical service use result from the loss of local GPservices yet, in this case, replacement with a new GP service, 2-years hence, did not ameliorate that effect after six years.ConclusionsThese findings demonstrate the immediate impact of GP-service loss on the rates ofaeromedical transfer of patients from this remote community and lend caution to expectations about thetimeline over which newly implemented primary health care services in such contexts can mitigate the impact of such a loss

AB - BackgroundThe Royal Flying Doctor Service (RFDS) provides aeromedical care to patients during fixed-wing transport over vast distances to healthcare unavailable in rural or remote communities. This study examined the relationship between changes in local accessibility to primary healthcare services and rates of aeromedical service use over time.MethodsThis was a 13-year interrupted time-series study (1999–2012) in Tennant Creek, Northern Territory. Quarterly aeromedical service use for primary care sensitive conditions were calculated and exposure to general practice (GP) services was characterised over time with events modelled as intervention variables: (a) GP service withdrawal (Nov-2004); and (b) GP service replacement (Dec-2006). Intervention effects were estimated using PROC ARIMA in SAS after examination of the time-series structure.ResultsGP withdrawal resulted in an immediate and sustained doubling in quarterly aeromedical service use (+11.8 services per quarter) and GP service replacement had no significant effect.DiscussionLarge and immediate increases in aeromedical service use result from the loss of local GPservices yet, in this case, replacement with a new GP service, 2-years hence, did not ameliorate that effect after six years.ConclusionsThese findings demonstrate the immediate impact of GP-service loss on the rates ofaeromedical transfer of patients from this remote community and lend caution to expectations about thetimeline over which newly implemented primary health care services in such contexts can mitigate the impact of such a loss

U2 - 10.1186/s12913-015-1110-y

DO - 10.1186/s12913-015-1110-y

M3 - Article

VL - 15

SP - 1

EP - 7

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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ER -