Barriers to the use of urban medical services by rural and remote area households.

People from rural and remote areas commonly need to attend provincial and metropolitan cities for specialist care. There decisions to make such trips 'away' involve a number of non-medical considerations that include economic, emotional and social factors. This paper reports the results of two surveys that sought information about the types and importance of non-medical considerations taken into account by rural and remote Queensland householders when faced with a trip away. In addition, the problems encountered by respondents on their last trip away are reported and discussed. The data revealed that important considerations taken into account when planning the trip were predominantly related to urgency, household organisation and the costs likely to be incurred where away. A number of avoidable problems occurring at destination were also described. Generally, remote area respondents saw these impediments as more serious barriers to seeking care than did rural area respondents. When respondents were further asked to identify major problems associated with their last trip to an urban facility, problems at the destination figured more prominently, particularly problems directly related to the lack of understanding of the transport and distance needs of rural people. With one exception, these problems were reported by similar proportions of rural and remote area respondents. These are matters that merit high priority attention in any programs to enhance access to specialist medical services by people in rural and remote areas.