A systematic review of health service interventions to reduce use of unplanned health care in rural areas

Brainard, Julii Suzanne, Ford, John A., Steel, Nicholas and Jones, Andy P (2016) A systematic review of health service interventions to reduce use of unplanned health care in rural areas. Journal of Evaluation in Clinical Practice, 22 (2). pp. 145-155. ISSN 1356-1294

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Abstract

Rationale, aims and objectives: Use of unplanned health care has long been increasing, and not enough is known about which interventions may reduce use. We aimed to review the effectiveness of interventions to reduce the use of unplanned health care by rural populations. Methods: The method used was systematic review. Scientific databases (Medline, Embase and Central), grey literature and selected references were searched. Study quality and bias was assessed using Cochrane Risk of Bias and modified Newcastle Ottawa Scales. Results were summarized narratively. Results: A total of 2708 scientific articles, reports and other documents were found. After screening, 33 studies met the eligibility criteria, of which eight were randomized controlled trials, 13 were observational studies of unplanned care use before and after new practices were implemented and 12 compared intervention patients with non-randomized control patients. Eight of the 33 studies reported modest statistically significant reductions in unplanned emergency care use while two reported statistically significant increases in unplanned care. Reductions were associated with preventative medicine, telemedicine and targeting chronic illnesses. Cost savings were also reported for some interventions. Conclusion: Relatively few studies report on unscheduled medical care by specifically rural populations, and interventions were associated with modest reductions in unplanned care use. Future research should evaluate interventions more robustly and more clearly report the results.

Item Type: Article
Uncontrolled Keywords: health services research,public health,systematic review
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 22 Mar 2016 09:14
Last Modified: 14 Sep 2019 00:07
URI: https://ueaeprints.uea.ac.uk/id/eprint/57668
DOI: 10.1111/jep.12470

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