HEALTH-SERVICE PROVISION IN RURAL AND REMOTE AREAS - A NEEDS ANALYSIS

Objectives: To assess the health service needs of rural and remote pop ulations and to examine the relationship between these needs as obtain ed from available data and as perceived by community general practitio ners (GPs) and other health providers. Design: Existing census and res earch data were used to study the Huon and Channel health district of South-East Tasmania. Primary data collection consisted of structured i nterviews with medical practitioners and community representatives. Re sults: Serious health problems are widespread in rural and remote area s as a result of socioeconomic conditions arising from economic recess ion and unemployment and pre-existing lifestyle and cultural attitudes towards health, low educational levels, isolation and lack of transpo rt. General practice and primary health care provision follow urbanisa tion and decrease with increasing distance from a major rural centre, as do the incidence of poverty and worsening health problems. Conclusi ons: Most primary health care in rural and remote areas is provided by GPs, with curative services predominating. The health service pattern s conform to lower socioeconomic patterns in that preventive health is given a low priority. Preventive health programs should tie in with c urative 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 p reventive health service delivery.