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Specialist outreach services in regional and remote Australia: key drivers and policy implications

Belinda G O'Sullivan, Johannes U Stoelwinder and Matthew R McGrail
Med J Aust 2017; 207 (3): . || doi: 10.5694/mja16.00949
Published online: 7 August 2017

Promoting the supply, distribution and sustainability of rural outreach services requires multilevel policy development and regional service planning

The need for more local specialist services to support rural communities is well established as a significant issue in Australia. Although the specialist workforce is growing, providers are increasingly choosing to subspecialise and work in metropolitan practice.1 Access to medical specialists in major cities is consistently high at 162.1 full-time equivalent specialists per 100 000 population, but diminishes for people living in inner or outer regional (82.7 and 61.5 per 100 000 respectively) and remote areas (34.2 per 100 000).2


  • 1 School of Rural Health, Monash University, Bendigo, VIC
  • 2 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC



Acknowledgements: 

This publication used data from the MABEL longitudinal survey of doctors conducted by the University of Melbourne and Monash University (the MABEL research team). Funding for MABEL comes from the National Health and Medical Research Council (Health Services Research grant, 2008–2011; Centre for Research Excellence in Medical Workforce Dynamics, 2012–2016) with additional support from the Department of Health (2008) and Health Workforce Australia (2013). Belinda O’Sullivan was supported by a Postgraduate Publications Award from Monash University.

Competing interests:

No relevant disclosures.

  • 1. Health Workforce Australia. Health workforce 2025. Vol 3: medical specialties. Adelaide: Health Workforce Australia, 2012. http://pandora.nla.gov.au/pan/133228/20150419-0017/www.hwa.gov.au/sites/uploads/HW2025_V3_FinalReport20121109.pdf (accessed Nov 2016).
  • 2. Australian Institute of Health and Welfare (AIHW). Medical Workforce 2015. Canberra: AIHW, 2016. http://www.aihw.gov.au/workforce/medical/additional (accessed Nov 2016).
  • 3. de Roodenbeke E, Lucas S, Rouzaut A, Bana F. Outreach services as a strategy to increase access to health workers in remote and rural areas. (Technical Report No. 2). Geneva: World Health Organization, 2011. http://whqlibdoc.who.int/publications/2011/9789241501514_eng.pdf (accessed Nov 2016).
  • 4. Simm PJ, Wong N, Fraser L, et al. Geography does not limit optimal diabetes care: use of a tertiary centre model of care in an outreach service for type 1 diabetes mellitus. J Paediatr Child Health 2014; 50: 471-475.
  • 5. Gruen RL, Bailie RS, Wang Z, et al. Specialist outreach to isolated and disadvantaged communities: a population-based study. Lancet 2006; 368: 130-138.
  • 6. Thomas CL, O’Rourke PK, Wainwright CE. Clinical outcomes of Queensland children with cystic fibrosis: a comparison between tertiary centre and outreach services. Med J Aust 2008; 188: 135-139. <MJA full text>
  • 7. Medlin LG, Chang AB, Fong K, et al. Indigenous Respiratory Outreach Care: The first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia. Aust Health Rev 2014; 38: 447-453.
  • 8. Ojo EO, Okoi E, Umoiyoho AJ, Nnamonu M. Surgical outreach program in poor rural Nigerian communities. Rural Remote Health 2013; 13: 2200.
  • 9. Finger RP, Kupitz DG, Holz FG, et al. Regular provision of outreach increases acceptance of cataract surgery in South India. Trop Med Int Health 2011; 16: 1268-1275.
  • 10. O’Sullivan BG, Joyce CM, McGrail MR. Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective. Bull World Health Organ 2014; 92: 512-519.
  • 11. O’Sullivan B, Joyce C, McGrail M. Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution. Hum Resour Health 2014; 12: 1-10.
  • 12. O'Sullivan BG, McGrail MR, Stoelwinder JU. Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study. Hum Resour Health 2017; 15: 1-7.
  • 13. O’Sullivan B, McGrail M, Joyce C, Stoelwinder J. Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study. Aust Health Rev 2016; 40: 330-336.
  • 14. O’Sullivan B, Stoelwinder J, McGrail M. The stability of rural outreach services: a national longitudinal study of specialist doctors. Med J Aust 2015; 203: 297. <MJA full text>
  • 15. O'Sullivan B. Rural outreach by specialist doctors in Australia [PhD thesis]. Melbourne: Monash University, 2016. http://arrow.monash.edu.au/hdl/1959.1/1268685 (accessed June 2017).
  • 16. O’Sullivan B, McGrail M, Stoelwinder J. Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study. Aust Health Rev 2017; 41: 344-350.
  • 17. Turner AW, Mulholland WJ, Taylor HR. Coordination of outreach eye services in remote Australia. Clin Exp Ophthalmol 2011; 39: 344-349.

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