Understanding How Rurality Relates to Residents' Experiences of Accessing Primary Care: An Interview-Based Study

To explore the experience of local residents when accessing primary care across different levels of rurality.

Four discrete regional, rural, and remote communities in Queensland, Australia, categorised by the Modified Monash Model classification.

Residents from a regional centre (n = 15), a small rural town (n = 9), and two remote or very remote communities (n = 6).

Semi-structured interviews using thematic analysis with both deductive and inductive coding.

Common challenges across all levels of rurality included limited primary care provider availability, long wait times, and disrupted care continuity, though their impact varied by the level of rurality. Regional centre residents predominantly experienced availability and timeliness challenges, while the small rural town residents faced availability, timeliness, and geography challenges. The remote and very remote communities experienced interconnected challenges, including a lack of permanent primary care providers, extensive travel, disrupted care continuity, and poor understanding of the community culture by some primary care providers. A key finding was 'geographic fragility,' which increased with the level of rurality, where remote community residents had to weigh up whether their health needs justified the burden of accessing primary care.

This study highlights the need for nuanced, context-specific approaches for improving primary care access across different levels of rurality, with particular attention to geographic fragility in remote and very remote communities. Policy implications include developing targeted workforce strategies, addressing timeliness challenges, and implementing flexible service models to ensure equitable access to primary care for all Australians.