title: A 'One Stop' Prostate Clinic for rural and remote men: a report on the first 200 patients.
abstract: OBJECTIVE
  To report on the structure and outcomes of a new 'One Stop' Prostate Clinic (OSPC) designed specifically for rural and remote men.
  
  
  METHODS
  Prospective cohort study of the first 200 rural or remote men to access a new OSPC at a public tertiary-level hospital in Western Australia between August 2011 and August 2014. Men attended for urological assessment, and proceeded to same-day transrectal ultrasonography-guided prostate biopsies, if appropriate. Referral criteria were either two abnormal age-related prostate-specific antigen (PSA) levels in the absence of urinary tract infection (UTI), or an abnormal digital rectal examination (DRE) regardless of PSA level.
  
  
  RESULTS
  The median (range) distance travelled was 1545 (56-3229) km and median (range) time from referral to assessment was 33 (2-165) days. The median (range) age was 62 (38-85) years, PSA level was 6.7 (0.5-360) ng/mL and 39% (78/200) had a suspicious DRE. In all, 92% (184/200) of men proceeded to prostate biopsies, and 60% (111/184) of these men were diagnosed with prostate cancer. Our complication rate was 3.5% (6/172). Radical prostatectomy (46/111), active surveillance (28/111) and external beam radiation therapy (26/111) were the commonest subsequent treatment methods. A $1045 (Australian dollars) cost-saving per person was estimated based on the reduced need for travel with the OSPC model.
  
  
  CONCLUSIONS
  The OSPC is an effective and efficient model for assessing men suspected of having prostate cancer living in rural and remote areas of Western Australia, and this model may be applicable to other areas.
authors.affiliation: Fiona Stanley Hospital, Murdoch, Australia.|Fremantle Hospital, Fremantle, Australia.|School of Surgery, University of Western Australia, Crawley, Australia.
authors.forename: Steve P
authors.initials: SP
authors.lastname: McCombie
authors.affiliation: Fiona Stanley Hospital, Murdoch, Australia.|Fremantle Hospital, Fremantle, Australia.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hawks
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Australia.|University of Melbourne, Parkville, Australia.|Western Health, Melbourne, Vic, Australia.
authors.forename: Jon D
authors.initials: JD
authors.lastname: Emery
authors.affiliation: Fiona Stanley Hospital, Murdoch, Australia.|Fremantle Hospital, Fremantle, Australia.|School of Surgery, University of Western Australia, Crawley, Australia.|West Australian Urologic Research Organisation, Perth, WA, Australia.
authors.forename: Dickon
authors.initials: D
authors.lastname: Hayne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000379:methods*; D019468:Disease Management; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012017:Referral and Consultation; D012424:Rural Population; D014904:Western Australia
keywords: health care delivery; prostate cancer; rapid access; rural health