Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia

To the Editor: Recruitment and retention of a sustainable rural health workforce was one of four issues highlighted by Osborne in a recent MJA supplement.1 Chapter 4 of the Supplement describes a need for longitudinal methods to evaluate recruitment and retention of nursing and allied health professionals, noting challenges around scale and links to policy.2 Comparative efforts examining the medical workforce in Australia are more advanced (eg, the Medical Schools Outcomes Database). Chapter 5 concludes there is a need for a longitudinal, linked database to address rural workforce planning that utilises public data sources, noting medicine was covered by all primary data sources identified, yet only three covered all health professions.3

The Nursing and Allied Health Graduate Outcome Tracking (NAHGOT) study is a research collaboration between the University of Newcastle, Monash University and Deakin University that addresses issues of scale and relevance to national health workforce policy. NAHGOT links Australian Health Practitioner Regulation Agency practice location data (the outcome) with university administrative records (explanatory variables including placement location and duration), and is complemented by the national Student Experience and Graduate Outcomes Surveys. Further complementing the NAHGOT database are the publicly available Socio‐Economic Indexes for Areas at varying spatial resolutions (eg, Statistical Areas Level 1 to Level 4), a general measure of spatial access (Australian Statistical Geography Standard — Remoteness Areas), and a workforce specific model used to define Distribution Priority Areas (Modified Monash Model).

Across the nursing and allied health disciplines offered by the three universities, data from a new cohort of about 2000 first year students are captured annually and securely stored in a central, de‐identified repository. Database access is currently restricted to participating institutions, with the longer term intent to permit external data extractions based upon predefined study protocols through a formal process. To our knowledge, NAHGOT is the largest tracking study of this type and growing, with three other universities soon to join the collaboration, enabling expansion into Queensland and South Australia.

All participating universities are funded by the Rural Health Multidisciplinary Training Program, with the study design reflecting the objectives of the federal Department of Health. Universities are the logical choice to undertake tracking of graduate outcomes at scale. Unlike other data sources, universities hold admission and professional placement data not available elsewhere. The protocol will soon be available4 and the first peer reviewed publications from NAHGOT have now been published,5,6 and as the project expands it is anticipated it will become a major contributor to workforce planning and augment established efforts in medicine.