Research Program

Nowhere is the problem of access to health services greater than in rural and remote areas. Poor access and social inequity are not confined to non-metropolitan areas. However, for geographically large countries such as Australia and Canada, these problems translate into major inequities in resource distribution and service provision. The consequent inequalities in the health and well-being of rural and remote citizens, especially Aboriginal and Torres Strait Islander people, are unacceptable.  Problems of access to services have persisted over time, and remain the single biggest impediment to improving the health outcomes of geographically disadvantaged groups of the population.  For this reason, the National Health and Hospitals Reform Commission targeted the issue of equity as one of its four main foci requiring action.

Comprehensive primary health care (PHC) services that include health promotion, early intervention, acute and chronic care, and rehabilitation are central to increasing equity in health outcomes. Moreover, our previous research has shown that a systemic approach to providing effective, sustainable models of PHC services diminishes one of the primary causes of health inequity, namely problems of health workforce recruitment and retention. Central to achieving equitable health outcomes is getting “the right mix of services in the right place at the right time”.
In order to develop effective policies that increase equity of access to quality health care, it is necessary to identify which services should be available to the diverse communities characterising Australia. It is also vital to understand how these services can be sustained and adapt to changing needs, and what sentinel measures policy-makers and service providers should use to monitor the impact of improved access to appropriate PHC on health behaviour and health outcomes.

Three integrated streams of research will operate within the CRE research program:

Stream 1 will measure access to PHC and service utilisation:

This research will refine and apply a national ‘Index of Access to PHC services’ that links service availability with the health needs of different communities, thereby enabling providers to evaluate the impact of service performance on health behaviour, service utilisation and health outcomes;

Stream 2 will develop an appropriate evaluation framework for PHC service access and equity:

This research will develop and trial the most appropriate indicators and their corresponding benchmarks for PHC services (for example, workforce size and mix) and performance (for example, early intervention, treatment of acute and chronic disease) that can be used to quantify the volume and distribution of available care (that is, ‘who gets how much of what services’) after taking account of population size, location and need; and

Stream 3 will develop and evaluate sustainable PHC service models:

That minimise barriers (such as distance and affordability) and maximise access to care.  This research will highlight PHC models that work best to deliver optimal care in different contexts, particularly focussing on aged care, mental and Indigenous health.

In short, the CRE for accessible and equitable primary health service provision research program will provide systematic evidence and identify objective criteria relating to the nature, volume, and distribution of the resources required to overcome problems of poor access to PHC services and to deliver equal health outcomes. This new knowledge will provide health consumers, service providers and policy-makers charged with implementation of current health reform with the evidence that enables them to plan, monitor and evaluate the equitable provision of health care for all Australians.

Related research projects:

  1. Beyond the Workforce Crisis: Advancing Conceptual Understanding in Rural and Remote Health, A/Prof L Bourke, Dr JE Taylor, Prof JS Humphreys & Prof J Wakerman (ARC Discovery Grant project).
  2. Making a Difference: The Elmore Primary Health Service Study, Prof JS Humphreys, Dr R Tham, Dr P Buykx & A/Prof L Kinsman (Rotary Health and Department of Health and Ageing Grant)
  3. Medicine in Australia: Balancing Employment and Life (MABEL): The Australian Longitudinal Survey of Doctors, Prof A Scott, Dr C Joyce, Prof JS Humphreys & A/Prof G Kalb (NHMRC Grant).
  4. Cardiac health in rural Australia: Access to quality primary care, A/Prof L Kinsman, Prof JS Humphreys, A/Prof S Campbell and A/Prof M Jones.