Overcoming access and equity problems relating to primary health care services in rural and remote Australia
Nowhere is the problem of access to health services greater than in rural and remote areas. “Lack of access to quality healthcare providers is one of the primary root causes of health inequity and is disproportionately experienced by people living in remote and rural communities”. While poor access and social inequity are not confined to nonmetropolitan areas, for geographically large countries such as Australia and Canada, this problem translates into major inequities in resource distribution and service provision in rural and remote areas, with consequent unacceptable inequalities in the health and wellbeing of their populations. For example, rural and remote Australians have poorer health outcomes, die sooner than people living in urban areas, and Medicare has a $1 billion underspend on people in rural and remote areas. Not only are problems of access to services at the heart of health outcome inequalities and inequities, but importantly they have persisted over time, and remain the single biggest impediment to improving the health outcomes of geographically disadvantaged groups of the population. The Centre of Research Excellence in Rural and Remote Primary Health Care (CRERRPHC) was launched in 2011 at Parliament House in Canberra by the Honourable Mr Mark Butler, the Minister for Mental Health and Ageing (see Figure 1). The CRERRPHC was established to undertake research on access and equity issues in relation to rural and remote primary health care (PHC). This focus is premised on the following:
- The inequality of health outcomes between the one-third of Australia’s population living in rural and remote regions and their metropolitan counterparts is unacceptable;
- The acute compounding effect of geography on socio-economic disadvantage in rural and remote areas;
- Evidence that effective PHC services diminish problems of workforce recruitment and retention;
- Evidence that PHC services are the most efficient and effective vehicle for improving health outcomes; and
- A logic model that provides the explanatory associations between health service inputs in specific contexts, service outputs and health outcomes.