Recruiting and retaining general practitioners in rural practice: systematic review and meta-analysis of rural pipeline effects.
Australia
Career Choice
Education, Medical, Undergraduate
General Practitioners
/ statistics & numerical data
Health Workforce
Humans
Internship and Residency
Personnel Selection
Primary Health Care
/ statistics & numerical data
Residence Characteristics
Rural Health Services
/ supply & distribution
General practice
Health personnel
Healthcare disparities
Rural health services
Systematic review
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
12
02
2019
accepted:
24
03
2020
pubmed:
23
7
2020
medline:
23
12
2020
entrez:
23
7
2020
Statut:
ppublish
Résumé
To synthesise quantitative data on the effects of rural background and experience in rural areas during medical training on the likelihood of general practitioners practising and remaining in rural areas. Systematic review and meta-analysis of the effects of rural pipeline factors (rural background; rural clinical and education experience during undergraduate and postgraduate/vocational training) on likelihood of later general practice in rural areas. MEDLINE (Ovid), EMBASE, Informit Health Collection, and ERIC electronic database records published to September 2018; bibliographies of retrieved articles; grey literature. Of 6709 publications identified by our search, 27 observational studies were eligible for inclusion in our systematic review; when appropriate, data were pooled in random effects models for meta-analysis. Study quality, assessed with the Newcastle-Ottawa scale, was very good or good for 24 studies, satisfactory for two, and unsatisfactory for one. Meta-analysis indicated that GPs practising in rural communities was significantly associated with having a rural background (odds ratio [OR], 2.71; 95% CI, 2.12-3.46; ten studies) and with rural clinical experience during undergraduate (OR, 1.75; 95% CI, 1.48-2.08; five studies) and postgraduate training (OR, 4.57; 95% CI, 2.80-7.46; eight studies). GPs with rural backgrounds or rural experience during undergraduate or postgraduate medical training are more likely to practise in rural areas. The effects of multiple rural pipeline factors may be cumulative, and the duration of an experience influences the likelihood of a GP commencing and remaining in rural general practice. These findings could inform government-led initiatives to support an adequate rural GP workforce. PROSPERO, CRD42017074943 (updated 1 February 2018).
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
228-236Informations de copyright
© 2020 AMPCo Pty Ltd.
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