In Australia, approximately one third of the population live in rural areas. Another half a million people live in remote regions of the country. [1] Rural and remote communities are often not well served by support services and networks in palliative care. [2] People living in rural and remote areas have higher levels of illness and disease risk factors, and less access to employment, education and income. [3]
There are a range of unmet needs for rural palliative care patients and their families, including access to palliative care services, information about illness, practical care and support. [1] A decrease in the number of GPs in many rural areas means less medical input and less choice when being cared for at home. Accessing after hours care can be problematic. Distances to travel in conjunction with a lack of transport is also a very real issue, as are isolation and loneliness.
Primary healthcare providers are pivotal in palliative care provision in rural and remote Australia. GPs will often care for patients throughout the disease trajectory and with admission rights to local hospitals, can often manage much of this locally.
The palliative care services in rural areas also have unmet needs in terms of their own support, educational requirements, access to specialist symptom management and ways to facilitate communication between service providers. [4] Primary healthcare providers in the absence of a palliative care service will also face many of the same issues.
It is also important to note that rural Australians have more of a sense of community, with the support mechanisms that this entails.