Health service provision in rural and remote areas: a needs analysis.

OBJECTIVES: To assess the health service needs of rural and remote populations and to examine the relationship between these needs as obtained from available data and as perceived by community general practitioners (GPs) and other health providers.

DESIGN: Existing census and research data were used to study the Huon and Channel health district of South-East Tasmania. Primary data collection consisted of structured interviews with medical practitioners and community representatives.

RESULTS: Serious health problems are widespread in rural and remote areas as a result of socioeconomic conditions arising from economic recession and unemployment and pre-existing lifestyle and cultural attitudes towards health, low educational levels, isolation and lack of transport. General practice and primary health care provision follow urbanisation and decrease with increasing distance from a major rural centre, as do the incidence of poverty and worsening health problems.

CONCLUSIONS: Most primary health care in rural and remote areas is provided by GPs, with curative services predominating. The health service patterns conform to lower socioeconomic patterns in that preventive health is given in low priority. Preventive health programs should tie in with curative health service provision, making use of the resources already available within the communities. The primary role taken by rural GPs in health service provision demands that they take a pivotal role in preventive health service delivery.