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The stability of rural outreach services: a national longitudinal study of specialist doctors

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Outreach health care services by medical specialists, involving travel away from their normal practice to underserved areas, is a key strategy to promoting access to such services in rural Australia. Evidence shows that rural outreach clinics can improve access to specialist services, reducing hospitalisations1 and achieving similar clinical outcomes to metropolitan-based clinics.2,3 The degree to which specialists continue to visit the same town over time is important to sustaining access and supporting follow-up care. About one in five Australian specialists provides rural outreach services,4 but we do not know how stable these services are.

The available evidence about the continuity of rural outreach services is scant, localised to individual services, and descriptive in nature. One small-scale qualitative evaluation has shown how service structure and design can influence outreach sustainability, but it was restricted to a remote setting.5 Case studies of successful ongoing outreach services by a selected range of specialist types in both rural and regional settings have been reported.1,6,7

A parliamentary…