Abstract
What does it cost to provide equity of access to high quality, comprehensive primary health care in rural Australia? A pilot study
Highlights
Equity of access to primary health care (PHC) services is a fundamental goal of rural health policies and planning
Because relevant national data were not available, and given the resource intensiveness of a bottom-up approach[26], the present study focused on applying a largely top-down costing approach to a sample of similar high performing rural PHC services located in different geographical settings, with a view to costing the inputs necessary to provide a comprehensive suite of core PHC services, and ascertaining how these costs might vary according to geographical location and community size
It would be useful to benchmark the costs associated with providing high quality PHC services in rural communities of different population sizes, in order to maximise funding equity based on evidence-based formulae rather than antiquated historical funding formulae or the ‘squeaky wheel gets the grease’ syndrome[31,32]
Summary
Equity of access to primary health care (PHC) services is a fundamental goal of rural health policies and planning. Discussion: This research highlights several significant issues that need to be addressed in seeking to benchmark rural PHC services: (1) ensuring consistency across the particular services being costed in different locations, (2) consistently determining the patient population within the service catchment, (3) categorising service models, taking into account extended service provision arrangements, (4) ensuring comprehensive collection of all costs and (5) other methodological issues including disaggregating data, defining high performing services and their sustainability over time. Many rural and remote communities are characterized by significant inequities in PHC service availability, quality/performance and sustainability[3] This variation reflects the nature of PHC services required by different communities, the costs of providing them, and specific barriers to their delivery, with both community size and geographical remoteness among the key determinants. Governments and health service providers continue to seek ways to improve equity of access to PHC
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