Are Queensland s new GP obstetricians going where they are needed?

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1 Are Queensland s new GP obstetricians going where they are needed? An analysis of the destination hospitals of graduates of the Queensland Rural Generalist Program National Rural Health Conference May 2015 Darwin Convention Centre Associate Professor Ruth Stewart Director of Rural Generalist Training, Queensland Rural Generalist Program.

2 Qld Rural Generalist Pathway (QRGP) Roma Agreement 2005 a supported training pathway specialist level remuneration. May 2008 Medical Officers' (Queensland Health) Certified Agreement (No.1) st intake 2007

3 Aim of the Queensland Rural Generalist Program : to provide medical graduates with a supported training pathway and rural and remote communities with a skilled medical workforce

4 Aim of this study: To determine if QRGP DRANZCOG adv. are going where they are needed

5 Methodology identify the QRGP DRANZCOG adv. destinations from QRGP dataset. Map and analyse these with respect to: Australian Standard Geographical Classification - Remoteness Area (ASGC-RA), District of workforce Shortage status, Queensland Maternal and Perinatal Quality Council (QMPQC) maternity service group classification birthing numbers in rural and remote Queensland

6 Calculation of birthing numbers in rural areas related to a hospital Using Statistical Area Level 2 (SA2) birth data 1 Each rural and remote SA2 and its no. of births in 2013 was associated with a single hospital birthing service using: Proximity Highways Local knowledge Severe limitations of this methodology: Women freely choose where to birth, no compulsion to attend the closest birthing service Women may require a service with a higher clinical service level. 1.

7 Ayr, Queensland Health Destination Hospitals Beaudesert, Bowen, Cairns, Chinchilla, Dalby, Emerald, Gladstone, Gympie /Cooroy, Innisfail, Kingaroy, Logan Hospital, Longreach, Mackay, Nambour, Proserpine, Roma, Stanthorpe, Thursday Island, Toowoomba Townsville, Weipa

8

9 Number of births in area of destination hospitals >750 Ayr Hospital 194 Beaudesert 571 Bowen 13 Cairns 2699 Chinchilla 231 Dalby 202 Emerald 697 Gladstone 972 Gympie /Cooroy 514 Innisfail 382 Kingaroy 553 Longreach 142 Mackay 2111 Nambour 3702 Proserpine 389 Roma 231 Stanthorpe 196 Thursday Island 188 Toowoomba 2239 Townsville 4376

10 Birth numbers in destination hospital areas Number of births in draining SA2s in Series

11 Are the QRGP DRANZCOG grads going where the births are occurring? less than to less than to less than or greater

12 Are Destination hospitals in ASGC- RA rural and remote areas?

13 ASGC-RA of destination hospitals Major Cities (RA1) x2 hospitals (9%) inner regional areas (RA2) x8 hospitals (36.3%) outer regional areas (RA3) x9 hospitals (41%) remote areas (RA4) x NONE very remote areas (RA5) x3 (13.6%)

14 ASGC-RA 10 ASGC- RA rating of hospitals where Rural Generalists with DRANZCOG advanced are working RA 1 RA2 RA3 RA4 RA5

15 District of Workforce Shortage Destination community Ayr Hospital Beaudesert Bowen Cairns Chinchilla Dalby Emerald Gladstone Gympie /Cooroy Innisfail Kingaroy Logan Hospital Longreach Mackay Nambour Proserpine Roma Stanthorpe Thursday Island Toowoomba Townsville Weipa District of Workforce Shortage status No No Yes No No Yes yes Yes No Yes Yes No Yes Yes No yes yes No Yes No No Yes

16 Are Destination hospitals in Districts of Workforce shortage(dws)? Twelve (54%) are ten (46%) are not.

17 Queensland Maternal and Perinatal Quality Council Classification Group A: Specialist obstetric service with feto-maternal medicine and NICU Group B: Specialist obstetric service and special care nursery >2000 births/year Group C: Specialist obstetric service and special care nursery <2000 births/year Group D: Rural generalist obstetric service and general nursery >250 births/year Group E: Rural generalist obstetric service or primary midwifery care model and general nursery <250 births/year Group X: Public facilities without maternity services

18 Queensland Maternal and Perinatal Quality Council Classifications of destination hospitals A B C D E X Townsville Cairns Logan Hospital Nambour Toowoomba Beaudesert Emerald Gladstone Gympie /Cooroy Innisfail Kingaroy Mackay Proserpine Ayr Chinchilla Dalby Longreach Roma Stanthorpe Thursday Island Bowen Weipa

19 Queensland Maternal and Perinatal Quality Council Classification Group A: SpecialistO&G NICU Group B: Specialist O&G SCN >2000 births/yr Group C: SpecialistO&G SCN <2000 births/yr Group D: Rural generalist >250 births/yr Group E: Rural generalist obstetric service <250 births/yr Group X: Hospital has no maternity service

20 Summary Queensland Rural Generalists are going to rural or remote hospitals where there is a maternity service or intent to develop one. 77% are in Regional hospitals 13% are in remote hospitals 70% are working in GP led obstetric services

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