Authors' recommendations: While a great deal has been published on rural health and health care, relatively little of it says anything of great substance and a correspondingly small body of surgery-specific research is relevant here: Figure 3 demonstrates the limited range of topics in rural surgery covered by available systematic reviews, none of which are specific to or particularly enlightening for the concerns underlying this overview.While they provide insights into the general state of the rural healthcare literature, the reviews themselves are of variable quality, using insufficiently focused questions or selection criteria and potentially biased vote-counting (Grimshaw, 2002) as summarization methods. The single Cochrane review [Gruen (2003): section C of Appendix Table 1] adheres to the usual Cochrane standard of excellence.Review shortcomings reflect those of the largely descriptive literature which they cover and the few focused rural healthcare research issues that have been systematically addressed in either primary studies or reviews. The volume-outcome association is the obvious exception and is relevant but not confined to rural surgical service decision making.

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/RegionalizationSurgery2010tagm.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)