Specialist care visits outside the hospital by South Australian older adults.

ABSTRACT

BACKGROUND: Limited access to specialist medical services is a major barrier to healthcare in rural areas. We compared rural-urban specialist doctor consultations outside hospital by older adults (≥ 60 years) across South Australia. METHODS: Cross-sectional data were available from the South Australia's Department of Health. The Modified Monash Model (MM1-7) of remoteness was used to categorize data into rural (MM 3-4), remote (MM5-7), and urban (MM1-MM2) of participants in urban and non-urban South Australia. The analysis was conducted on older adults (n = 20,522), self-reporting chronic physical and common mental health conditions. RESULTS: Specialist doctor consultation in the past 4 weeks was 14.6% in our sample. In multivariable analysis, increasing age (odds ratio 1.3, 95% CI 1.2-1.4), higher education (odds ratio 1.5, 95% CI 1.3-1.9), physical health conditions [diabetes (odds ratio 1.2, 95% CI 1.1-1.3); cancer (odds ratio1.8, 95% CI 1.7-2.0); heart disease (odds ratio 1.9, 95% CI 1.6-2.1)], and common mental disorders [depression (odds ratio 1.3, 95% CI 1.1-1.5); anxiety (odds ratio 1.4, 95% CI 1.1-1.6)] were associated with higher specialist care use. Specialist care use among rural (odds ratio 0.8, 95% CI 0.6-0.9), and remote (odds ratio 0.8, 95% CI 0.7-0.9) older people was significantly lower than their urban counterparts after controlling for age, education, and chronic disease. CONCLUSION: Our findings demonstrate a disparity in the use of out of hospital specialist medical services between urban and non-urban areas.