Cargando…

Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service

BACKGROUND: Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific...

Descripción completa

Detalles Bibliográficos
Autores principales: Gonzalez-Chica, David, Gillam, Marianne, Williams, Susan, Sharma, Pritish, Leach, Matthew, Jones, Martin, Walters, Lucie, Gardiner, Fergus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077896/
https://www.ncbi.nlm.nih.gov/pubmed/33902590
http://dx.doi.org/10.1186/s12913-021-06404-5
_version_ 1783684970949115904
author Gonzalez-Chica, David
Gillam, Marianne
Williams, Susan
Sharma, Pritish
Leach, Matthew
Jones, Martin
Walters, Lucie
Gardiner, Fergus
author_facet Gonzalez-Chica, David
Gillam, Marianne
Williams, Susan
Sharma, Pritish
Leach, Matthew
Jones, Martin
Walters, Lucie
Gardiner, Fergus
author_sort Gonzalez-Chica, David
collection PubMed
description BACKGROUND: Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics. METHODS: Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15–49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20–34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination. RESULTS: A total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018–19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018–19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15–19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35–49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively). CONCLUSIONS: The proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers.
format Online
Article
Text
id pubmed-8077896
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-80778962021-04-29 Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service Gonzalez-Chica, David Gillam, Marianne Williams, Susan Sharma, Pritish Leach, Matthew Jones, Martin Walters, Lucie Gardiner, Fergus BMC Health Serv Res Research Article BACKGROUND: Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics. METHODS: Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15–49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20–34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination. RESULTS: A total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018–19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018–19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15–19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35–49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively). CONCLUSIONS: The proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers. BioMed Central 2021-04-26 /pmc/articles/PMC8077896/ /pubmed/33902590 http://dx.doi.org/10.1186/s12913-021-06404-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gonzalez-Chica, David
Gillam, Marianne
Williams, Susan
Sharma, Pritish
Leach, Matthew
Jones, Martin
Walters, Lucie
Gardiner, Fergus
Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title_full Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title_fullStr Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title_full_unstemmed Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title_short Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
title_sort pregnancy-related aeromedical retrievals in rural and remote australia: national evidence from the royal flying doctor service
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077896/
https://www.ncbi.nlm.nih.gov/pubmed/33902590
http://dx.doi.org/10.1186/s12913-021-06404-5
work_keys_str_mv AT gonzalezchicadavid pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT gillammarianne pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT williamssusan pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT sharmapritish pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT leachmatthew pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT jonesmartin pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT walterslucie pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice
AT gardinerfergus pregnancyrelatedaeromedicalretrievalsinruralandremoteaustralianationalevidencefromtheroyalflyingdoctorservice