Still the doctor - by a country mile! Preferences for health services in two country towns in north-west New South Wales.

OBJECTIVE To evaluate whether rural consumer preferences for health services have changed over time or vary across communities with different models of health service delivery. DESIGN Questionnaire survey replicating a 1989 study, with ranking of seven different healthcare services. PARTICIPANTS AND SETTING Adult occupants from a 20% sample of private residences, in towns and on farms, in the rural shires of Bogan and Warren in north-west New South Wales. The survey was conducted in September 2002. MAIN OUTCOME MEASURES Rank order of preferences for different healthcare services; preference structure intervals showing relative "distance" between preferences. RESULTS Response rates were 68% (Nyngan town), 78% (Nyngan farms) and 59% (Warren town). The doctor was the most valued health service in rural communities, followed by the hospital. These preferences occurred regardless of age, sex or place of residence, persisted over time, and were similar for residents of towns with different models of healthcare service provision. CONCLUSIONS Rural people, both in towns and on farms, rate acute primary healthcare services provided by the doctor and hospital as the two most important services. These preferences have not changed substantially after a decade of restructuring rural health services and reorienting them towards a primary healthcare approach. The stability of rural consumer preferences may reflect a bias towards the status quo.