What does it cost to provide equity of access to high quality, comprehensive primary health care in rural Australia? A pilot study

Introduction: Equity of access to primary health care (PHC) services is a fundamental goal of rural health policies and planning. Unfortunately, many rural and remote communities are characterised by significant inequities in PHC service availability, quality/performance and sustainability. This article investigates how best to ascertain the costs of delivering high quality PHC services across different geographical locations through reporting the research findings from a pilot study. The aim of the study was to ascertain whether it is possible to estimate the total, per capita and per consultation costs of providing high quality PHC services in rural locations of different population sizes, and to describe the methodological issues associated with such an exercise. Methods: A retrospective, top-down approach was used. A sample of high performing primary care practices in rural communities was identified using data from the Australian Primary Care Collaborative (APCC) program. The researchers selected practices in rural communities (Australian Standard Geographical Classification remoteness areas 2 and 3) and assigned a population count using Australian Bureau of Statistics census data (urban centre locality). Four population groups of different sizes were chosen: 101–500, 501–1000, 1001–3000 and 3001–5000. A data collection tool was developed to capture information describing annual operating costs (both capital and recurring), human resources, PHC services provided and reflections from practice principals on issues related to provision of sustainable high quality primary care in a changing environment. Financial data available from practice