Verdon Sarah, Wilson Linda, Smith-Tamaray Michelle, McAllister Lindy
School of Community Health, Charles Sturt University, Albury, Australia.
Int J Speech Lang Pathol. 2011 Jun;13(3):239-50. doi: 10.3109/17549507.2011.573865.
The World Health Organization's equity objective states that there should be equal access to healthcare for equal need, regardless of location. Disparities between health services and challenges to achieving the equity objective have been documented both in Australia and around the world. However, little is known about the extent to which this objective has been met in the field of speech-language pathology in Australia. This study used structured interviews with 74 speech-language pathologists working in rural areas of New South Wales and Victoria. The data obtained were used to develop maps to describe the availability of paediatric speech-language pathology services through consideration of location and frequency. The findings show that 98.60% of localities are unserviced at the ideal frequency of weekly or more often. It is important to note that these percentages include all localities in the represented rural areas of New South Wales and Victoria, some of which are minimally populated. The maps also depict travel and distance as barriers to the accessibility of services and have been used to suggest a critical maximum distance for paediatric outpatient speech-language pathology services in rural New South Wales and Victoria. From the data collected, 50 kilometres was suggested as the critical maximum distance past which consumers become unable or unwilling to travel to access weekly rural speech-language pathology services in rural New South Wales and Victoria. Thus, people living in almost one third of rural localities in rural New South Wales and Victoria lie beyond what is considered by rural speech-language pathologists to be a reasonable travel distance to weekly speech-language pathology services. These results highlight barriers to the achievement of equitable services in rural areas. The results also provide an essential foundation to inform policy development and assist health service planning to meet the needs of rural consumers.
世界卫生组织的公平目标指出，无论身处何地，对于同等需求的人群应提供平等的医疗保健服务。澳大利亚及世界各地都记录了卫生服务之间的差距以及实现公平目标所面临的挑战。然而，对于澳大利亚言语病理学领域在多大程度上实现了这一目标，人们知之甚少。本研究对在新南威尔士州和维多利亚州农村地区工作的74名言语病理学家进行了结构化访谈。所获得的数据被用于绘制地图，通过考虑地点和频次来描述儿科言语病理学服务的可及性。研究结果显示，98.60%的地区未达到每周或更频繁的理想服务频次。需要注意的是，这些百分比涵盖了新南威尔士州和维多利亚州所代表的农村地区的所有地点，其中一些地区人口稀少。这些地图还将出行和距离描绘为服务可及性的障碍，并被用于提出新南威尔士州和维多利亚州农村地区儿科门诊言语病理学服务的临界最大距离。根据收集到的数据，建议将50公里作为临界最大距离，超过这个距离，新南威尔士州和维多利亚州农村地区的消费者将无法或不愿意前往接受每周一次的农村言语病理学服务。因此，新南威尔士州和维多利亚州近三分之一农村地区的居民距离农村言语病理学家认为的每周言语病理学服务合理出行距离较远。这些结果凸显了农村地区实现公平服务的障碍。研究结果还为政策制定提供了重要依据，并有助于卫生服务规划以满足农村消费者的需求。
