Evidence map›Paper›PMID 33902590›Full record

ArticleBMC health services research2021

Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service.

David Gonzalez-Chica, Marianne Gillam, Susan Williams, Pritish Sharma, Matthew Leach, Martin Jones, Lucie Walters, Fergus Gardiner

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

David Gonzalez-ChicaAdelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA, 5005, Australia. david.gonzalez@adelaide.edu.au.
Marianne GillamDepartment of Rural Health, University of South Australia, Mt Barker, SA, Australia.
Susan WilliamsAdelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA, 5005, Australia.
Pritish SharmaRoyal Flying Doctor Service of Australia, Canberra, ACT, Australia.
Matthew LeachNational Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia.
Martin JonesDepartment of Rural Health, University of South Australia, Mt Barker, SA, Australia.
Lucie WaltersAdelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA, 5005, Australia.
Fergus GardinerRoyal Flying Doctor Service of Australia, Canberra, ACT, Australia.
University of Adelaide · AUUniversity of South Australia · AUSouthern Cross University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics.

methodsCross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15-49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20-34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination.

resultsA total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018-19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018-19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15-19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35-49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively).

conclusionsThe proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers.

Indexed as

Air AmbulancesAdolescentAdultAustralian Aboriginal and Torres Strait Islander PeoplesCross-Sectional StudiesFemaleHumansInfant, NewbornMiddle AgedNorthern TerritoryPregnancyRural PopulationSouth AustraliaYoung AdultAir ambulancesEmergency medical servicesMaternal health servicesPregnancy complicationsRural population

Identifiers

PMID33902590
PMCPMC8077896
OpenAlexW3159859006

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.