Delimiting 'rural': implications of an agreed 'rurality' index for healthcare planning and resource allocation

Rural and remote Australia is characterised by considerable geographical and social diversity. There is no 'natural' classification of what constitutes 'rural' or 'remote', and precise definition of what is meant by the term 'rural' has proved to be an elusive goal. Nonetheless, it is recognised that the differentiation of rural areas has important implications for healthcare planning and the research that underpins it. Whether it be the development of resource allocation formulae that determine the provision, location and type of rural health services, measuring service utilisation rates as an indicator of need for services or health outcome measures, the way in which populations and communities are delimited as urban, rural and remote will always influence and sometimes may even determine the assessment. The time is ripe for the development of an agreed classification for the investigation of rural health issues.