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Rural Road to Health


May 30, 2024

Dr Giovanni Baglio and Monica Brinzac join us to speak about the OASES project, a EU funded project looking at medical deserts in Europe.  

 

Episode summary:

00.50  Dr Giovanni Bagglio and Monica Brinzac tell us about their professional backgrounds and projects they are involved in

04.40  What is the OASIS project?

06.25  What are medical deserts?

10.30  How many areas of Europe are affected by medical deserts? 

13.40  What were the main goals of the project?

15.55  Who was involved in the project?

18.30  How were rural communities involved in the project?

20.05  What has the impact been for rural communities?

22.40  Is there a good understanding of the problem among urban stakeholders?

25.25  What were some of the key findings from the pilot studies?

31.10  What do they see as the next steps that are needed to address medical deserts?

 

Key Messages:

OASES is a project that aims to define and share methodologies and knowledge on how to measure medical desserts in order to develop common policies and strategies to address these challenges.  

There were seven European countries participating in the project: Italy, France, Cyprus, Romania, Moldova, Hungary and Finland.

Other EU  projects that are relevant are: AHEAD and ROUTE project which also address the issue of medical desserts;  METEOR ,focused on retention of healthcare workers,TASHI on task shifting.

Medical deserts are a complex phenomenon.  The project has adopted a composite definition:  Any situation where criticalities arise in the relationship between health needs, demand and supply of healthcare.  This includes not just the lack of health services but also situations where the quality of care is poor or certain populations do not have adequate access.

There are 3 dimensions that were explored: 1) availability, 2) quality, 3) accessibility and equity.  

From this a matrix was developed with specific indicators.

Each medical desert is unique, however they do have similarities such as the shortage of medical doctors in rural areas, and difficulty to access care due to an unequal distribution of services.

OASES aimed to provide a clear idea on the current situation in regard to medical desertification.  They then developed a set of measurement methods to ultimately develop a common language in Europe and try to address the challenges with common policy approaches.  

There were diverse partners, health systems and stakeholders that took part in the project, this was a strength of the project.  

We may all be living in a medical desert in 10 years time as it is projected that 40% of the current healthcare workforce will retire within that time. 

The project included communities and they discovered that the rural communities are the most disadvantaged as they have fewer healthcare facilities and fewer healthcare workers.  

Delayed access to care leads to worse health outcomes.  This also increases the costs for the health system.

One of the mitigation strategies that has been proposed is to offer financial incentives to medical professionals working in rural areas and to invest in improving the infrastructure in rural areas.  

This challenge needs to be tackled at all levels, with a bottom-up and top-down approach.  

Recommendations:

  1.  Increase the number of healthcare professionals.  

  2. Expand the role and scope of healthcare professionals.

  3. Financial incentives.

  4. Reorganize primary care delivery.

  5. Policies that support a well functioning health system.

  6. Utilizing digital technologies.

The biggest issue is the number of healthcare professionals as the majority of countries have an insufficient number of healthcare workers. 

Resources that do exist are not being utilized effectively. 

If people do not have access to a good quality service they will not choose to access it.  Quality is important.

There is a lack of reliable data to draw conclusions from.

Next steps involve implementing actions and recommendations and we need better data.  

 

Thank you for listening to the Rural Road to Health!