The EURIPA Study Defining and describing rural practice

1. The EURIPA StudyDefining and describing rural practice “Making the case for rural practice”

2. WONCA study • Funded by Wonca Europe • Scoping study • Across all of Europe • EURIPA Listserver • Problems • Response rate • Language/culture • Size and complexity of questionnaire • Quantitative/qualitative

3. Which Country do you practice in?

4. How is primary funded in your country?

5. Financial • Do you have a state health service • 89% • Is it insurance based • 57% • How do patients pay for services • Free service 61% • Nominal charge (return on justification) 19% • Nominal set fee 14% • Full cost 5%

6. Status of doctors in practice • How many doctors work in your practice • Average 4.6 (Range 1 to 16) • Distribution of doctors by • Gender • Male 56% Female 44% • Employment status • Full time: Male 87.8% Female 87.2% • Part time: Male 12.2% Female 12.8% • Qualification in Family Medicine • Male 53.2% Female 46.8% • How many hours a day do you work on average? • 6 hours (Range 6-14)

7. Status of staff • How many qualified nurses work in the practice • Average 3.7 (range 1-13) • Do practice staff have any qualifications in any area of medicine to contribute to primary care • Yes 47%

8. Population density

9. Population served

10. Does the location of your practice affect the following?

11. Practice details • What is your practice population • 3720 (range 1200 to 17000) • Average time spent with each patient • 12.4 minutes (5 to 20 minutes) • How soon are patients seen

12. Consultations, diagnostics and procedures • How do patients arrange a consultation • Appointments 80% • Just turn up! 20% • Can a patient have diagnostic tests and minor procedures conducted in the practice • 78%

13. Outreach and specialities • Does your practice provide a community mental health service • 47% • What outreach services are provided in your practice • Psychiatry • Paediatrics • Gynaecology • Physiotherapy • Laboratory

14. Obstetrics

15. Computer records

16. IT Skills • Are all staff who need to be computer literate? • 58% • Can your practice staff use IT to • Access /update computer records from own desk • 63% • Link to diagnostic services • 63% • Access specialist services • 31%

17. Distance and travel • How far is your practice from a district general hospital- 45 Km (Range 1 to 200 km)

18. Available transport for patients

19. Out of Hours Care • Other forms of Out of Hours Cover: • Local hospital • Country rota • Central town emergency service • Local traige esrvice • National call answering service (NHS 24)

20. Medication • How are prescriptions paid for? • Free 16% • Patient 11% • Subsidised 73%

21. Continuing Professional Development • Is evidence of CPD necessary to continue in practice? • 47% • Are there any incentives for undertaking CPD? • 36% • Do you perceive a need for a rural postgraduate qualification in family medicine? • 79% • Would you undertake such training? • 79%

22. Public health • Are preventative approaches to ill health explored in your practice • 95% • Do you follow a programme of illness reduction (WHO guidelines) • 84% • Do you have targets for some areas of medicine or disease improvement • 58% • Chronic conditions (diabetes, hypertension, COPD, CHD), terminal care, vaccination, anti-natal care adolescent abortions, communicable diseases, quality prescribing, use of diagnostic services. • Rewards for achieving targets in some countries

23. Complaints • Does your practice have a complaints procedure • 74% • Do you have a process for investigating critical incidents • 47%