Research Co-ordinator: Dr Claudio Carosino - ccarosino@tin.it
The rural health movement is gathering pace across Europe. Rural primary care research is in an early stage of development. Research activity varies - active foci exist in some countries while in others no rural research activity takes place. EURIPA conducted an eighteen-month project, which examined public health services across rural areas in Europe (funded under Biomed 2) from 1998 to 99. This concerted action project brought together rural health practitioners from across Europe to undertake the literature review.
EURIPA aims to:
Previous workshops and meetings have been part of an ongoing process, which intends to develop a European Rural Research Forum under the umbrella of EURIPA. The Research Group intend to link with the new European Section of the Journal of Rural and Remote Medicine to encourage practitioners across Europe to conduct and publish research.
EURIPA is currently undertaking a European wide study on acute chest pain. EURIPA members from 9 countries involving 12 practices are collecting data on the incidence and management of acute chest pain in rural practice which is remote from an acute centre.
The project considers:
At this point in time 123 cases have been reported and the study is scheduled to complete at the end of March 2010. The results so far show:
This project involved a number of EURIPA partners:
The overall aim of the project was to examine the evidence available on public health and health services in rural areas in European countries.
Its specific objectives were:
Method
The project used an extensive literature review and desk research to collect information. The literature review included papers written in all the project partners' main languages, which were Danish, English, Finnish, Greek, Spanish and Portuguese. The desk research involved gathering data from the partners' countries to provide a range of contextual information relevant to the project such as definitions of rurality, demographic characteristics of rural areas and information on recruitment/education of rural general practitioners.
Findings and recommendations
Examination of the evidence available showed that, although socio-economic conditions between countries varied, there were differences in the use of and access to healthcare services in rural areas compared with urban areas. Various alternatives such as mobile units and telemedicine have been tried to compensate for this, but their effectiveness has not been thoroughly proven. Extra funding for services in rural areas is available in some countries, but not all. Across the countries, rural general practices appeared to encounter similar problems. Although limited evidence was available, the problems included workloads, resources, and access to education and training. A lack of a consistent and robust definition of rurality, which makes the study results and statistical data difficult to interpret and therefore to compare, was identified.
Overall, more research and data collection is needed with sensitivity to the diversity of rural communities. The research agenda for future pan-European research identified by this project includes: