Inequalities in rural health care: differences in surgical intervention between metropolitan and rural Western Australia.
BACKGROUND
To compare surgical procedure rates between metropolitan and rural/remote residents in Western Australia (WA).


METHODS
The WA Data Linkage System was used to identify all patients who underwent a procedure for cataract, ureteric calculi or urinary outflow obstruction symptoms for the time periods 1981-2000, 1981-1997 and 1981-1995, respectively. Age-standardized procedure rates were calculated and Poisson regression modelling was used to estimate effects of locality of residence and demographic covariates.


RESULTS
Overall, rural/remote patients underwent first-time procedures for cataract (IRR 0.92; 95% CI 0.90-0.94), ureteric calculi (0.76; 0.72-0.80), or urinary outflow obstruction (0.71; 0.69-0.74) less frequently than patients in the metropolitan area. They were also significantly less likely to undergo multiple procedures for cataracts (0.90; 0.88-0.91) and ureteric calculi (0.69; 0.67-0.73).


CONCLUSIONS
A distinctly reduced level of surgical intervention was found in rural patients for three generally non-life threatening conditions. The reasons for this require further investigation.
Ng
Jonathon Q
JQ
Centre for Health Services Research, School of Population Health, The University of Western Australia, Crawley, WA 6009, Australia.
Hall
Sonjâ E
SE
Holman
C D'Arcy J
CD
Semmens
James B
JB
D000328:Adult; D000368:Aged; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D016012:Poisson Distribution; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D014545:Urinary Calculi / Q000601:surgery*; D014904:Western Australia