Factors in accessibility of general practice in rural Australia

Objective: To ascertain the importance rural Australians attribute to different factors of accessibility in their decision to consult a general practitioner. Design: Survey by interview or delivery-and-collection questionnaire (participant's choice) based on the method of paired comparisons. Setting and participants: All residents of 10 small rural communities in north-west New South Wales aged over 16 years in July and August 1996. Main outcome measures: Rank order and relative importance of residents' preferences for choosing to consult a particular doctor. Results: Social accessibility or acceptability considerations were more important than geographical proximity in the choices of rural residents to consult a particular doctor. Elderly people, in particular, attributed most significance to acceptability and continuity of care. Geographical proximity ranked most highly for young and middleaged people and men living in isolated communities. Conclusions: For rural inhabitants, geographical distance is not the sole or even the most important determinant in their choice of general practice care; rather, they will seek the services of a GP with whom they feel comfortable. Incentives programs designed to recruit and retain more GPs in rural practice must acknowledge the importance of attracting acceptable doctors. This requires that rural doctors acquire suitable clinical and communication skills to meet the diverse needs of their patients, as well as an understanding of rural culture.