Quality of rural primary health care: Including the consumer

Abstract

In rural Australia, models of primary health care are as diverse as the communities themselves. Differing facilities, health disciplines, individual providers, local contexts, funding models and reporting make measuring quality of care very difficult. This paper proposes that quality can be measured in three ways - through industry driven benchmarks, through consumer satisfaction, and through consumer and community decision-making. Further, this paper argues that quality of care needs to include a consumer domain. If consumers are able to influence how they receive support, care and/or treatment, they are more likely to receive appropriate services and interventions and have positive outcomes. A case study is presented to discuss how the three levels of quality are applied within a rural organisation, highlighting the challenges and effort required to sustain genuine community participation. The paper concludes with a discussion of these issues and the many challenges embedded in consumer-driven approaches to quality of care.