Medical staff shortages are forcing some regional, rural and remote communities to increasingly rely on emergency department workers for healthcare.
That comes as findings show the unaffordability of general practice (GP) services was more likely to deter rural and remote patients from seeking help when compared to metropolitan communities, according to an ABS study.
People living in poverty, outside metropolitan areas, who are older or chronically ill were more likely to be affected.
Senior research fellow at Melbourne University Dr Kristen Glenister described the compounding factors as "a perfect storm."
If GP or specialist treatment was delayed, patients could be forced to seek emergency care, she said.
A condition that's easily fixed when detected early might become more complex if left untreated.
- Dr Glenister
Patients in regional and rural areas are waiting longer for GP appointments than they think is reasonable, according to the ABS data.
Financial pressures and staff shortages were also forcing some regional and rural general medical practices to stop accepting new patients and limit or cut bulk billing.
That's because Medicare rebates had not kept pace with cost-of-business expenses and rural doctors typically had a low stream of patients.
"They're under huge financial pressures to make those practices viable," Dr Glenister said.
Patients had to factor in medications, referrals, pathology tests, medical imaging tests and other costs associated with seeing a doctor.
Rural Outreach support worker Judith Lalic, from Inverell in northern NSW, said that made it "difficult for people on a low incomes".
IN OTHER NEWS:
Access to specialists and telehealth
Australians using telehealth consultation services increased over the last year to 30.8 per cent due to advances in online health services that has improved video-call access to medical specialists for regional and rural communities.
Patients are increasingly open to using telehealth services with 85.4 per cent reporting they would access online consultations again.
However, the National rural health alliance warns investment in telehealth should not be a replacement for investing in rural health services.
"It's a great complimentary service but has the potential to contribute to inequality," Dr Glenister said.
Telehealth services may be more difficult to access for older, disabled, non-English speaking or financially disadvantaged patients, she said.
Impact of trauma
Regional and rural mental health patients were struggling to form care plans due to limited and expensive GP services and no alternative resources.
Without access to resources it was "easy for a person to develop an attitude that nobody cares about them," Ms Lalic said.
Patients' drug and alcohol addiction needed regular consultations with mental health specialists, which many are struggling to access.
Trauma was a major compounding factor at the core of some mental health, housing stability and addiction issues in poorer regional Australians, Ms Lalic said.
Regional areas typically faced delays in organising drug and alcohol rehabilitation services for socio-economically disadvantaged patients and that meant the window for effective treatment was brief.
"Patients need to be able to get into rehab then and there," she said.
"By the time we organise treatment for them they are not in a frame of mind to receive it."
Housing insecurity, and it's root causes, could also impact on a patients ability to seek medical care, she said.
Ms Lilac recounted the experience of a patient who avoided mental health medication to stay alert in unsafe sleeping conditions.
"A whole lot of things collapse in on one another and make it very difficult for disadvantaged patients," she said.
