Investigating high-risk rural regions for potentially preventable hospitalisations: a method for place-based primary healthcare planning.

Abstract

Background Inaccessibility of primary healthcare services in rural and remote communities is argued to lead to higher rates of potentially preventable hospitalisations. This research aimed to develop an explanatory method that could be applied for investigating a rural setting considered high risk for potentially preventable hospitalisations, and to describe how to improve place-based pathways to primary healthcare services that would prevent potentially preventable hospitalisations. Methods The method described in this paper provides a structured and detailed plan for examining regions identified as high risk for a particular potentially preventable hospitalisation condition. The method was developed and tested through a series of research studies on ear, nose and throat (ENT) conditions in the Murray Primary Health Network, that had regions identified as high-risk hotspots for ear, nose and throat potentially preventable hospitalisations. Results The procedure developed for investigating hotspot regions of potentially preventable ear, nose and throat hospitalisations included six steps: (1) develop investigative questions; (2) identify and select potentially preventable hospitalisations condition and region; (3) literature review of best practice service needs and service mapping; (4) healthcare provider and consumer experiences; (5) illustrate patient journey; and (6) summarise recommendations for primary health care. Conclusions This method provides an understanding of the access pathways to primary healthcare services, and identifies where interventions and prevention strategies would support residents in obtaining equitable health care. This developed method can be further applied and tested as a mechanism for health and service needs assessment by primary healthcare planning and coordination agencies, which in Australia include Primary Health Networks, public health units and hospital networks.