8th Health Services and Policy Research Conference 1

Dr Matthew McGrail attended (and presented a paper on the Index of Access at) the 8th Health Services and Policy Research Conference, 2-4 December 2013, Wellington NZ

Conference report

This was the first time that I had attended the conference of the Health Services Research Association of Australia and New Zealand. In the past I was somewhat apprehensive of this conference as it had a strong reputation of being dominated by health economics. While I did find there was a strong gathering of health economists, it was only a small component of the overall conference and their contribution blended well with the remainder of the conference.

The 9th Health Services and Policy Research Conference will be held in Melbourne in late 2015 and I fully expect to be an active participant then. Plans are underway (led by Tony Scott, CIA on the MABEL study (Medicine in Australia: Balancing Employment and Life)) for MABEL to run a pre-conference workshop at the 2015 conference – and I expect to be involved in this activity.

The mix of attendees at this conference was fantastic – better than I’ve found at other conferences which are centred on just rural health, public health or primary health care. Across the three days, I re-connected with many colleagues or met for the first time peers from diverse fields including primary health care, health policy, health economics, public health, health services researchers, NZ rural clinical schools. I also met with Nick Mays – UK professor of health policy and a few other rural health researchers. This blend fits extremely well with my research activities which, while centred on rural health, go across health services, primary health care and health policy research.

My attendance at this conference enabled me to present on the main outcome from our CRE, the Index of Access. This was a great opportunity to present this material (for the first time) to a wider audience and get some valuable feedback from a new audience’s perspective; previously, similar material has only been presented at invitation only or ‘closed’ meetings. Clearly, this was a great opportunity to promote my work, and also the work of our CRE (which is administered by the School of Rural Health) to this highly relevant audience. There are at least three planned publications to come from this work on the Index of Access – these are currently in various draft forms, and it is hoped that they will all be submitted to journals and reviewers by June 2014.

Thankyou to the School of Rural Health conference support committee for providing funds to help make this attendance possible.

Conference paper abstract

Development of a National Index of Access for Rural Primary Health Care
Matthew R. McGrail 1,2, John S. Humphreys 2
1 Monash University School of Rural Health; 2 Centre of Research Excellence in Rural and Remote Primary Health Care

Objectives
Ensuring equity of access to resources requires a fit-for-purpose geographical classification. In Australia, health resource allocation has relied upon classifications only approximating access to healthcare (such as remoteness or socio-economic classifications ASGC-RA or SEIFA), or simplistic access measures (such as provider-to-population ratios or distance to nearest services). This paper reports on progress by the Centre of Research Excellence in Rural and Remote Primary Health Care in developing a more appropriate national Index of Access for rural primary health care in Australia.

Methods
The Index of Access is founded on the two-step floating catchment area (2SFCA) method, and designed to take account of geographical location, ability to transcend distance, and the need for, and availability of, primary health care services. General practice workforce data were obtained from the Australian Medicare Benefits Schedule database, and compared with data from the Australian Medical Publishing Company.

Lessons learned
This paper presents the initial results. In particular, because of the critical importance of parameters underpinning such an index, considerable attention must be given to key assumptions relating to service and population catchments, population travel behaviour and health needs across diverse geographical regions. Our current research is seeking to validate previously-used assumptions associated with moving from a single state rural access measure in Victoria to a national-level measure of access.

Implications
A national Index of Access for primary health care policy will assist policy-makers in their quest to allocate resources underpinning the provision of rural primary health care service more equitably.

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