Lack of plastic surgeons based in regional Victoria costing rural patients millions of dollars

The study, a two-year retrospective evaluation of patients who underwent a procedure at Warrnambool Plastic & Reconstructive Surgery by Dr Toby Vinycomb, Dr Hanna Jones, Mr John Masters and Mr Robert Toma found there is significant increase in personal cost for travel and accommodation required for rural patients to access specialist care.

Background:

– 1,860 patients in the study.
– 3.5 per cent of Victorian plastic and reconstructive surgeons live and work in regional or rural areas – to cover 23 per cent of the Victorian population.
– Warrnambool is a two surgeon, one trainee plastic surgery unit that provides elective and emergency services to a population of 151,140 people and perform almost 2,500 operations/year.

Key findings include:

– Patients would pay on average at least an additional $1,201 in travel and accommodation for common and necessary operations to travel to Melbourne.
– Over a prospective 4-week period (204 patients) a total saving of $245,000 was achieved in travel and accommodation cost by attending a rural service.
– This does not factor in the increased cost of prolonged displacement to Melbourne on individual and family members and economic impact of increased time off work.
– 51 per cent of patients would prefer to travel an additional 30 mins or more to go to a rural service than travel to Melbourne whilst 93 per cent of respondent felt it very important to have a rural plastic surgery service.
– Total additional personal cost of travel and accommodation to patients if they had to travel to a metropolitan service over a two-year period was $1,707,740 for those attending South West Healthcare (Warrnambool), and reaches $6.36 million over all the health care services they operate in the South West Victorian region.
– Median travel distance was 28 km to our service compared to 259 km to the nearest metropolitan service.

Mr Toma, a Royal Australasian College of Surgeons (RACS) Fellow and Plastic and Reconstructive surgeon said regional and rural Victorian patients want to receive treatment close to where they live.

“What I would like to see is increased funding to attract sub-specialty surgeons to regional areas of Victoria,” Mr Toma said.

“When I relocated to Warrnambool a decade ago, there was initially a lack of understand regarding services plastic surgeons provided to the community. Fortunately, South West Healthcare, St John of God Hospital and Portland Hospital saw the benefit and supported my decision.

“Ten years on, the community is reaping the rewards of that decision because they don’t have to travel to Melbourne for surgery and be thousands of dollars worse off.”

Dr Toby Vinycomb, a Plastic Surgery registrar said the research highlights the disparity of services available to Victorians based in rural areas of the state.

“Rural and regional Victorians generally earn less than those based in Melbourne and Geelong, however, they are currently being asked to pay more to access health care,” Dr Vinycomb said.

“Surgeons who train in rural and regional areas of Victoria often want to return when their training is complete, however, there needs to be appropriate funding to make it happen.

“It’s a win-win situation. There will be more sub-specialty surgeons setting up shop throughout regional Victoria, which in turn will drastically reduce the amount Victorians based outside of the metro centres will have to pay to access health care.”

Mr Toma and Dr Vinycomb will be unveiled at the the Royal Australasian College of Surgeons Annual Scientific Congress in Brisbane (2-6 May).

The Congress is the largest multi-disciplinary surgical meeting held in the southern hemisphere and brings together some of the top surgical and medical minds from across New Zealand, Australia, and the rest of the world.

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