Higgins Maddie, Gurney Tiana, McGrail Matthew
Rural Clinical School, The University of Queensland, Brisbane, Queensland, Australia.
Aust J Rural Health. 2025 Aug;33(4):e70080. doi: 10.1111/ajr.70080.
To assess the comparative importance of dimensions of access when accessing primary care across different levels of rurality in Australia.
A quantitative survey using the paired comparison method.
Regional, rural, and remote communities in Queensland, Australia, are defined by the Modified Monash Model classification.
3204 households were surveyed, with 192 responses received (6% response rate). After data cleaning, 163 usable surveys were included in the final analysis.
MAIN OUTCOME MEASURE(S): Level of importance for seven dimensions of access: availability, geography, affordability, accommodation, timeliness, acceptability, and awareness.
Awareness was the most important dimension, consistent across all ruralities. Timeliness and availability also ranked highly, though their relative importance varied slightly with the level of rurality. Residents of the regional centre and small rural town ranked timeliness second, while remote and very remote community residents ranked availability second. Geography increased in importance as rurality increased, rising from least important for regional centre residents to mid-level importance for remote and very remote residents. Affordability consistently ranked low in importance across all ruralities.
This study reveals differences in the importance of dimensions of access when accessing primary care for residents of regional, rural, and remote Australian communities. These findings suggest that strategies to improve primary care access should be tailored to address the most critical factors across different levels of rurality, focusing on improving awareness, availability, and timeliness of primary care services. The increased importance of geography in the remote and very remote community highlights the need for innovative solutions to overcome geographical barriers for these residents.
评估在澳大利亚不同农村地区获得初级医疗服务时，可及性各维度的相对重要性。
采用配对比较法的定量调查。
澳大利亚昆士兰州的地区、农村和偏远社区根据改良莫纳什模型分类进行界定。
对3204户家庭进行了调查，收到192份回复（回复率6%）。数据清理后，最终分析纳入163份可用调查。
可及性七个维度的重要性水平：可获得性、地理位置、可负担性、便利性、及时性、可接受性和知晓度。
知晓度是最重要的维度，在所有农村地区均一致。及时性和可获得性排名也很高，不过它们的相对重要性随农村程度略有变化。地区中心和农村小镇的居民将及时性排在第二位，而偏远和极偏远社区的居民将可获得性排在第二位。随着农村程度增加，地理位置的重要性上升，从地区中心居民最不重要升至偏远和极偏远居民的中等重要性。可负担性在所有农村地区的重要性排名一直较低。
本研究揭示了澳大利亚地区、农村和偏远社区居民在获得初级医疗服务时，可及性各维度重要性的差异。这些发现表明，改善初级医疗服务可及性的策略应量身定制，以解决不同农村程度的最关键因素，重点是提高初级医疗服务的知晓度、可获得性和及时性。地理位置在偏远和极偏远社区重要性的增加凸显了为这些居民克服地理障碍的创新解决方案的必要性。
