Hospital pressure grows as rural health gap widens

National data has revealed hospitals are under more pressure than ever before, while rural and remote Australians experience the highest rates of hospitalisation.
 
A series of reports released by the Australian Institute of Health and Welfare (AIHW) explored hospitalisations (2023–24), low-urgency emergency department (ED) presentations (2022–23) as well as ‘potentially preventable hospitalisations’ (2022–23).
 
Data shows the number of patient-admitted hospitalisations in public and private hospitals increased from 10.2 million to 12.6 million over the past decade, from 2014–15 to 2023–24.
 
Over the same period, rates increased from 405 to 421 per 1000 population.
 
Hospitalisation rates were highest for people living in ‘very remote’ and ‘remote areas’ (817 and 542 per 1000 population, respectively), and lowest for those living in major cities (410 per 1000 population).
 
In public hospitals, admission rates ranged from 667 per 1000 population for people living in very remote areas to 227 per 1000 for people in major cities.
 
‘Remote’ and ‘very remote’ patients also experienced the highest rates of potentially preventable hospitalisations at around twice the rate of people living in major cities.
 
Adding to the health challenges in country communities, AIHW data shows ‘remote’ and ‘very remote’ Australians had 1.8 and 1.6 times the rates of lower urgency ED presentations than people living in ‘inner regional’ and ‘outer regional’ areas respectively, and 3.2 times the rates as people living in major cities.
 
RACGP Rural Chair Associate Professor Michael Clements said the AIHW data reflects what is felt on the ground in rural and remote areas and builds on previous research that has shown rural Australians get a smaller share of Medicare and Pharmaceutical Benefits Scheme funds.
 
‘Rural and remote patients are certainly dealing with poorer access to their GP and to a clinic that knows them,’ he told newsGP.
 
‘This data is showing that when people have less access to their GPs for preventative care, they present a lot later on in their disease, with more advanced diabetes, heart disease, lung disease, and are more likely to need admission.
 
‘And certainly, for many of our rural and remote communities, that also means retrieval to a centre that might be many, many hundreds of kilometres away.’
 
Despite the challenges, Associate Professor Clements is hopeful future data will show the tide is turning, as rural-focused incentives start to have impact.
 
‘We have actually seen some positive changes to address rural challenges and certainly in the last 12–24 months we’ve had a very significant increase in the rurally focused billing incentive – that has made a difference in terms of increasing patient rebates so that they could access more care in rural areas,’ he said.
 
He also notes a rise in GP registrars taking up training in hard-to-fill rural and remote communities in light of a range of targeted incentives and support.
 
The upcoming bulk-billing incentives announced as part of the 2025 Federal Election are also likely to have an impact, providing greater access to affordable healthcare for country patients, Associate Professor Clements said.
 
‘There’s been a lot of noise about that in the media, questioning whether the policy will really achieve nine out of 10 patients getting access to bulk billing.
 
‘I can tell you that they certainly will in rural and remote areas because those incentives are rurally focused, and we are absolutely expecting to see a significant opening up of access to patients to bulk-billed appointments in rural communities.
 
‘I can say that because I’m one of them.’
 
At the same time as hospitals are under this immense pressure, Federal Health and Ageing Minister Mark Butler marked a milestone in the Federal Government’s urgent care clinics (UCC) initiative.
 
This week he announced that more than 1.5 million Australians had received care at a UCC as part of the Federal Government’s strategy to alleviate pressure on busy emergency departments.
 
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