Equitable resourcing of primary health care in remote communities in Australia's Northern Territory: a pilot study

John Wakerman, Lisa Sparrow, Susan L. Thomas, John S. Humphreys, Mike Jones

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Improved Primary Health Care (PHC) utilisation is central to reducing the unacceptable morbidity and mortality rates characterising populations living in remote communities. Despite poorer health, significant inequity characterises the funding of PHC services in Australia's most remote areas. This pilot study sought to ascertain what funding is required to ensure equitable access to sustainable, high quality primary health care irrespective of geographical remoteness of communities. Methods: High performing remote Primary Health Care (PHC) services were selected using improvement measures from the Australian Primary Care Collaboratives Program and validated by health experts. Eleven PHC services provided data relating to the types of services provided, level of service utilisation, human resources, operating and capital expenses. A further four services that provide visiting PHC to remote communities provided information on the level and cost of these services. Demographic data for service catchment areas (including estimated resident population, age, Indigenous status, English spoken at home and workforce participation) were obtained from the Australian Bureau of Statistics 2011 census. Formal statistical inference (p-values) were derived in the linear regression via the nonparametric bootstrap. Results: A direct linear relationship was observed between the total cost of resident PHC services and population, while cost per capita decreased with increasing population. Services in smaller communities had a higher number of nursing staff per 1000 residents and provided more consultations per capita than those in larger communities. The number of days of visiting services received by a community each year also increased with population. A linear regression with bootstrapped statistical inference predicted a significant regression equation where the cost of resident services per annum is equal to $1,251,893.92 + ($1698.83 x population) and the cost of resident and visiting services is equal to $1,378,870.85 + ($2600.00 x population). Conclusions: The research findings provide empirical evidence based on real costs to guide funding for remote PHC services that takes into account the safety and equity requirements for a minimum viable service. This method can be used as a transparent, coordinated approach to ensure the equitable delivery of sustainable, high quality PHC in remote communities. This will in turn contribute to improved health outcomes.

LanguageEnglish
Article number75
Pages1-12
Number of pages12
JournalBMC Family Practice
Volume18
Issue number1
DOIs
Publication statusPublished - 29 Jun 2017

Fingerprint

Northern Territory
Primary Health Care
Health Services
Costs and Cost Analysis
Population
Quality of Health Care
Linear Models
Health
Patient Acceptance of Health Care
Nursing Staff
Censuses
Population Groups
Referral and Consultation
Economics
Demography

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • primary health care
  • remote
  • equity
  • access
  • cost
  • benchmark
  • funding

Cite this

Wakerman, John ; Sparrow, Lisa ; Thomas, Susan L. ; Humphreys, John S. ; Jones, Mike. / Equitable resourcing of primary health care in remote communities in Australia's Northern Territory : a pilot study. In: BMC Family Practice. 2017 ; Vol. 18, No. 1. pp. 1-12.
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Equitable resourcing of primary health care in remote communities in Australia's Northern Territory : a pilot study. / Wakerman, John; Sparrow, Lisa; Thomas, Susan L.; Humphreys, John S.; Jones, Mike.

In: BMC Family Practice, Vol. 18, No. 1, 75, 29.06.2017, p. 1-12.

Research output: Contribution to journalArticleResearchpeer-review

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