Imbalances in rural primary care: the risk of a primary care vacuum in rural and remote areas
Rural and remote areas have an ageing population, with increasing health needs and a shrinking carrying capacity for community functions. Also in terms of health care, rural populations are disadvantaged: health care systems generally fail to reach urban and rural populations equally.
The combination of increasing demand for care and undersupply of health care services can lead to a primary care vacuum in rural areas. Many countries, large and small, with lower as well as higher population density, recognize the challenge of providing accessible and good quality primary care in rural and remote areas.
There is a risk of a downward spiral: primary care shortage may lead to an erosion of availability, accessibility and quality of primary care in rural areas. Against growing health needs of an ageing and often poorer population, health care services face outdated facilities and equipment and ageing staff. Hospitals and specialised services are further away and are, at times, not well available for back-up care in rural settings. As a consequence the gap in quality of care between rural and urban populations tends to grow as a result of the primary care shortage.
The following four groups of strategies can be identified to address the primary care shortage:
- shifting tasks within multidisciplinary primary care teams to other health care professionals that are more likely to stay in rural areas than physicians
- recruiting and retaining more staff in rural areas
- promoting the mobility of health care workers and patients
- implementing technological innovations in information and communication.
This webinar is based on a Policy Brief of WHO and a background report prepared by a team from NIVEL, consisting of dr. Mark Bosmans, dr. Wienke Boerma and professor Peter Groenewegen.