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It's Tuesday so I must be in... why I choose to act as a locum.

https://arctichealth.org/en/permalink/ahliterature161220
Source
Can Fam Physician. 2007 Feb;53(2):300-1
Publication Type
Article
Date
Feb-2007

Research methodology for the investigation of rural surgical services.

https://arctichealth.org/en/permalink/ahliterature167843
Source
Can J Rural Med. 2006;11(3):187-94
Publication Type
Article
Date
2006
Author
Erik Ellehoj
Joshua Tepper
Brendan Barrett
Stuart Iglesias
Author Affiliation
Reserch and Evidence Branch, Alberta Health and Wellness.
Source
Can J Rural Med. 2006;11(3):187-94
Date
2006
Language
English
Publication Type
Article
Keywords
Alberta
Catchment Area (Health)
Delivery of Health Care
General Surgery
Geographic Information Systems
Health Services Accessibility
Health Services Research - methods
Hospitals, Rural
Humans
Ontario
Regional Medical Programs
Research
Rural Health Services
Rural Population - classification
Suburban Population - classification
Time
Travel
Abstract
This paper describes a functional approach to the definition of rural populations for purposes of rural health care research. Rather than define "rural" directly, we created a definition of urban populations and our research target became the non-urban component. Using Geographic Information Systems technology, isochrones (drivetime zones) were created that attached suburban populations to urban centres and mapped non-urban populations into rural hospital catchment areas. For population-based analyses, we have proposed a methodology for constructing catchment areas attached to Rural, Regional and Metropolitan services. We have developed a model for calculation of travel time for patients required to travel for care. We successfully applied these methodologies to the disparate regions of rural Alberta and Northern Ontario in 2 papers that investigated the delivery of rural surgical services. This methodology represents a durable and portable designation of "rural" with potential for research applications in other areas of health research. By defining "urban" rather than "rural," we avoided many of the methodological conundrums in this research field.
PubMed ID
16921665 View in PubMed
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Rural surgical services in two Canadian provinces.

https://arctichealth.org/en/permalink/ahliterature167884
Source
Can J Rural Med. 2006;11(3):207-17
Publication Type
Article
Date
2006
Author
Stuart Iglesias
Joshua Tepper
Erik Ellehoj
Brendan Barrett
Peter Hutten-Czapski
Kir Luong
William Pollett
Author Affiliation
Rural Family Physician, Gibsons, BC.
Source
Can J Rural Med. 2006;11(3):207-17
Date
2006
Language
English
Publication Type
Article
Keywords
Alberta
Catchment Area (Health)
Family Practice - manpower
Humans
Ontario
Regional Medical Programs - manpower
Rural Health Services - manpower - supply & distribution
Specialties, Surgical - manpower
Surgical Procedures, Operative - utilization
Travel
Abstract
Contrast alternative health delivery systems and the use of differently trained physician providers in the supply of surgical services to rural residents in 2 Canadian provinces.
Four surgical procedures (carpal tunnel release, inguinal herniorrhaphy, appendectomy and cholecystectomy) provided to rural residents of Alberta and Northern Ontario were identified between 1997/98 and 2001/02. Surgical staff were identified as specialists or non-specialists. Rural populations were mapped into the catchment areas of rural acute care facilities. Rural surgical programs were characterized by the level of surgical service available locally.
Alberta and Northern Ontario have a similar number of rural surgical programs staffed by Canadian-certified general surgeons (10 and 12, respectively). However, Alberta has 27 smaller rural surgical programs staffed by non-specialist surgeons and Northern Ontario has only 4. These non-specialist surgeons play a significant role in Alberta, often in collaboration with specialist surgeons. In Northern Ontario the non-specialist surgeons play a minor role. The small rural surgical programs in Northern Ontario that are staffed by specialist surgeons are significantly more successful in retaining the local surgical caseload compared with similar programs in Alberta.
The principal differences between Alberta and Northern Ontario in the delivery of rural surgical services are the greater number of small rural surgical programs in Alberta, and the substantial role of non-specialist surgical staff in these programs.
PubMed ID
16914079 View in PubMed
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Utilization rates for surgical procedures in rural and urban Canada.

https://arctichealth.org/en/permalink/ahliterature167885
Source
Can J Rural Med. 2006;11(3):195-203
Publication Type
Article
Date
2006
Author
Joshua Tepper
William Pollett
Yan Jin
Erik Ellehoj
Peter Hutten-Czapski
Don Schopflocher
Brendan Barrett
Stuart Iglesias
Author Affiliation
Institute of Clinical Evaluative Sciences, Toronto, ON M4N 3M5.
Source
Can J Rural Med. 2006;11(3):195-203
Date
2006
Language
English
Publication Type
Article
Keywords
Alberta
Appendectomy - utilization
Carpal Tunnel Syndrome - surgery
Catchment Area (Health)
Cholecystectomy - utilization
Health Services Accessibility - statistics & numerical data
Health Services Research
Hip Fractures - surgery
Hospitals, Rural - utilization
Hospitals, Urban - utilization
Humans
Ontario
Rural Population
Surgical Procedures, Operative - classification - utilization
Thyroidectomy - utilization
Time
Travel
Urban Population
Abstract
To investigate whether utilization rates of common surgical procedures are different between urban and rural Canadians in 2 provinces and to examine whether these rates are influenced by the presence and scope of local surgical programs and by the availability of different physician providers.
Utilization rates for 8 common surgical procedures (appendectomy, carpal tunnel release, closed hip fracture repair, rectal cancer surgery, joint replacement, thyroidectomy, unilateral or bilateral inguinal herniorrhaphy, and cholecystectomy) were identified in rural Alberta and rural Northern Ontario from hospital discharge records. Rural populations were characterized by 3 types of communities, based on availability of local physician and diagnostic resources. Travel time for consultations and surgery were estimated. Age-sex-adjusted rates, their standard errors, and 95% confidence intervals (CIs) were calculated for the purpose of comparisons among residents' locations using the method of direct standardization. To test a possible association between travel times and utilization rates, hierarchical linear and nonlinear modelling was used to analyze a 2-level model, with patients nested within rural hospital catchment areas in the province of Alberta.
Utilization rates for appendectomy, cholecystectomy and carpal tunnel release are significantly greater for rural populations compared with urban in both Alberta and Northern Ontario. Rural Northern Ontario had higher rates of utilization than rural Alberta for carpal tunnel release and cholecystectomy (p
PubMed ID
16914078 View in PubMed
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