'Better than nothing': clinicians and hospital heads accept lower standards of care outside metro hospitals

live in rural and remote areas and many struggle to access the same quality of health care as those in metropolitan areas. or signup to continue reading More than 18,000 Australians have to primary health care services within an hour's drive time from their home, and many are hours or even multiple days' drive from their closest major hospital. Travel to a major city to access health care is costly and time-consuming.

Rural Australians have than those in major cities. People living in rural and remote Australia have substantially higher levels of preventable hospitalisations, burden of disease, and avoidable deaths. This leaves a gap in median between people in very remote areas and major cities of 13 years for men and 16 years for women.



Our shows clinicians and health care decision-makers are willing to accept a lower standard of care for people outside of major cities because they consider it better than nothing. Our research investigated Queensland clinicians' and health care decision-makers' perspectives on virtual health care as a means to improve access to care. We also asked about what constitutes acceptable quality and standards for rural patients.

Although we used virtual health care as an example, the results are indicative of a broader issue. "Virtual health care" is more than just telehealth. It includes: Virtual health care can time to major cities, keeping patients better connected with their family and community while undergoing treatment.

However, virtual health care is not currently suitable for patients who require intensive care, some types of physical procedures, or for patients at high risk of complications. Virtual services need to be well-designed, with appropriately trained clinicians, and consider what can and cannot be accomplished remotely. When virtual health care isn't well designed, and clinicians aren't adequately trained, it can result in poor patient outcomes.

As one doctor explained: I can catalogue just over the last month, I've seen errors in telehealth [...

] They've missed pneumonia, they've missed kidney stones, they've missed a bowel obstruction, they've missed an ischaemic valve, they've missed an MI [myocardial infarction]. You know, all because they think they can do all these things on telehealth [..

.]. We interviewed 26 clinicians (such as doctors and nurses) and executive leaders from private, not-for-profit hospitals and aged care services in metropolitan, regional, rural and remote Queensland in 2023.

Most participants expressed reticence towards using telehealth and other forms of virtual health care for people in major cities who can readily access traditional hospitals and providers face-to-face. They felt safety and care standards would be inferior to traditional inpatient care. However, they said virtual health care - even if it was a lower standard to traditional hospitals - was better than nothing.

As one doctor and health service leader said: there's no other choice is there, so you just do it that way. Another doctor and health service leader explained: But we would use it for sure. I mean especially those days when we get, you know, which is becoming more and more common where the hospital rings down there's no beds.

There's no beds and you're like, well, what do I do now I've got ten people here and nowhere to send them. Sub-standard health care will not bring health outcomes and life-expectancy of people in rural and remote areas up to parity - it will merely reinforce current inequities. We need to design health services that improve both quality and access.

Taking health-care models that work in our major cities and rolling them out in rural areas doesn't work. We need tailored, creative solutions that meet the same standards we would expect in a city. In addition to increasing and improving access to virtual health care, we also need to: An unconscious willingness to accept better than nothing is simply not good enough for the millions of Australians who live outside of major cities.

, Senior Research Fellow, Applied Implementation Science, ; , Research Fellow, Health Services, , and , PhD Candidate/Health and Health Services Researcher, This article is republished from under a Creative Commons license. Read the . DAILY Today's top stories curated by our news team.

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