Hauora Taiwhenua Rural Health Network is pleased to announce the winners of the three Rural Student Research Scholarships for the 2023/24 year. Two of the Scholarships were to support health students to support a 12-week elective/studentship, and/or research placement within a rural community of the student’s choice. A BNZ Rural Development scholarship was also available to any year two and above Medical Student for the same period.
Read below for the three recipients for the 2023/24 year, with a summary of the research that they each will be undertaking below.
Understanding Inequity in Access to Specialised Healthcare in Rural Communities within Aotearoa
Access to specialised healthcare is a critical aspect of public health, and rural communities often face challenges in this regard. This is an issue highlighted strongly by the latest New Zealand Health & Disability System Review, which stated that an unacceptable level of service accessibility has been witnessed to be forced upon our rural communities. This research aims to investigate the factors contributing to the inequity in accessing specialised healthcare services within rural communities.
This project will explore the access to rural healthcare and will assist in guiding rural health professionals in achieving a provision of care that aligns with both patient and whānau values, in order to improve the access and utilisation of services within our rural communities – a current focus for networked hospital and specialist service delivery of the Te Pae Tata Interim New Zealand Health Plan (2022)
A comprehensive investigation into inequity in accessing specialised healthcare services in the rural community of Kaitaia will take place. By utilising a mixed-methods approach, we aim to gain a holistic understanding of the barriers individuals face in accessing and using these services. The outcomes of this study hold the potential to inform policy and drive positive change, contributing to the betterment of rural healthcare in Kaitaia and beyond. To focalise this research, we will be specifically looking at the referrals made to the Orthopaedic Service at Kaitaia Hospital for any knee-related surgeries. By shedding light on these barriers, we aim to contribute valuable insights that can inform targeted interventions to improve access to rural healthcare services.
Discrepancies in clinical coding in rural vs. urban hospitals
Last summer, I completed the Te Kōunga o Te Hiringa Gary Coghlan Studentship Programme through Te Whatu Ora Te Tai o Poutini. As part of a team, we developed a framework for health volunteers in the Greymouth area so that they could be better utilised by the hospital.
This summer, I will be completing a rural research studentship looking at any discrepancies in clinical diagnosis codes for interhospital transfer between rural and urban hospitals. I will be based rurally on the West Coast of the South Island for the completion of this.
The aims of this project are to:
Identifying any discrepancies is important because this determines the accuracy of population-based analysis of administrative datasets and may limit the accuracy of any reporting of rural-urban differences in health outcomes. I will be supervised by Dr Rory Miller, a rural hospital doctor and GP and a rural-based academic for the University of Otago Department of General Practice and Rural Health.
Our study will be a retrospective observational analysis using NMDS. An abstract for presentation at the National Rural Health Conference will be submitted and the findings will be presented in a peer-reviewed open-access journal and promoted on other open-access platforms.
Strengths and weaknesses of paediatric patient discharge advice communicated to whānau; A Qualitative Study
Rural Aotearoa communities with poorer health outcomes are often the furthest away from base hospitals with the lowest amount of resources available however, they are also often overlooked in the picture of health across Aotearoa. Although less ethnically diverse than urban Aotearoa, rural areas have a larger proportion of people who identify as Māori. Kaitaia is one such community that shares these rural community health characteristics. Paediatric patients may either be admitted to Kaitaia Hospital, a rural general hospital serving a widely scattered population of approximately 21,000 people or can be transferred to a secondary service, Whangārei Hospital. However, all people in the Kaitaia region are >100 minutes distance from their base hospital in Whangārei, adding a layer of complexity to healthcare in the far North.
I am undertaking a Quality Improvement project at Kaitaia Hospital about the way discharge advice is communicated to paediatric patients and their whānau (families). Patients can be those who were discharged from either Kaitaia Hospital or Whangārei Hospital and live in the Kaitaia region. Most of the discharge information of paediatric patients is communicated to caregivers so this project uses semi-structured phone interviews in order to capture the strengths and weaknesses of discharge advice from the whānau perspective.
The idea for this Quality Improvement project came from growing up rurally in Ohakune and seeing my own whānau be admitted to hospital. I noticed a discrepancy in the communication of knowledge upon discharge and often reflected on “safety netting” on discharge as a concept. Through my medical training at the University of Auckland, I have become very interested in patient experiences of hospital services and the importance of effective clinician-patient communication. My aim is that this research may act as a voice for the community of Kaitaia to highlight areas of development for health professionals when giving advice to paediatric patients and whānau on discharge.