Remoteness

People with disability aged under 65 living in the community in Outer regional and Remote areas are less likely than those living in Major cities to see a GP, medical specialist, or dentist (Figure 1). But they are more likely to visit a hospital emergency department. These patterns are also evident for the general Australian population.

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Based on self-reported data, people with disability aged under 65 living in the community in Outer regional and Remote areas are more likely than those living in Major cities to:

 


Outer regional and Remote


Major cities

visit a hospital emergency department for care they felt could be provided by a GP

16%

10%

indicate that the time of day or day of week was the main reason they went to a hospital emergency department instead of a GP on the most recent occasion

25%

17%

wait longer than they felt acceptable for an appointment with a GP

30%

20%

wait longer to see a GP for urgent medical care (more than 1 day)

28%

22%

face difficulties caused by lack of communication among types of health professionals in the coordination of their care(a)

20%

16%

receive only informal assistance for health-care activities(b)

53%

42%

have difficulty accessing medical facilities (GP, dentist or hospital)(c)

44%

37%

(a) Proportion of those who saw 3 or more health professionals for the same health condition.

(b) Proportion of those aged 5–64 who needed help with health-care activities.

(c) Proportion of those aged 5–64 who had difficulty accessing buildings or facilities in the last 12 months.

Source: ABS 2016; see also tables S2, S5, S8 and S11.

The higher rate of use of hospital emergency departments for non-hospital services in Outer regional and Remote areas partly occurs within a broader context of health services supply—type, volume and geographical distribution. Data from the Medical Workforce Survey indicates that the supply of employed medical practitioners, especially non-GPs, decreases with remoteness, with most tending to be concentrated in urban areas (AIHW 2016a; AIHW 2016b).

Other factors for understanding these differences include a higher proportion of people with disability living in Outer regional and Remote areas reporting that:

  • the time of day or day of week was the main reason they went to a hospital emergency department instead of a GP
  • the main reason their need for formal health-care assistance remained unmet was because they ‘did not know of service’, were ‘unable to arrange service’ or there were ‘no services available’ (Figure 2).

This suggests that some people with disability in these areas may use a hospital emergency department as their point of contact with the health system because of the unavailability of other health services or a lack of communication or understanding about what services are available.

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References

ABS (Australian Bureau of Statistics) 2016. Microdata: disability, ageing and carers, Australia, 2015. ABS cat. no. 4430.0.30.002. Canberra: ABS. AIHW analysis of Confidentialised Unit Record File.

AIHW (Australian Institute of Health and Welfare) 2016a. Medical practitioners workforce 2015. Viewed 13 November 2017, https://www.aihw.gov.au/reports/workforce/medical-practitioners-workforce-2015/contents/how-many-medical-practitioners-are-there.

AIHW 2016b. Australia’s health 2016. Australia’s health series no. 15. Cat. no. AUS 199. Canberra: AIHW.