title: Costs of accessing surgical specialists by rural and remote residents.
abstract: BACKGROUND
  Access to surgical specialist services by rural and remote residents in Australia is limited. Little information is available on the cost to rural residents of accessing specialist treatment. The aim of the present study was to define the personal costs incurred by country patients in Western Australia when accessing specialist surgical services in a rural or metropolitan setting.
  
  
  METHODS
  A random sample of 50 patients who attended a visiting rural surgical service between December 1998 and February 1999 inclusive was recruited. In a structured telephone interview patients were asked 40 non-clinical questions relating to their recent specialist consultation. The cost of accessing these services was determined from time lost from work, distance and travel expenses. The same formula was then applied to estimate the cost of attending a base metropolitan hospital. The need for an accompanying person was determined from a subset of 16 patients who had transferred to metropolitan specialist consultation in the previous 12 months. Average waiting list times for consultations and common surgical procedures for the visiting service were compared with those for a metropolitan-based service.
  
  
  RESULTS
  An estimated saving of AU$1,077 was made per specialist consultation when accessing a local rather than a metropolitan service. Savings were observed in travel time, distance travelled, lost income, provision of an escort and waiting time.
  
  
  CONCLUSIONS
  The present study shows that the personal costs and difficulties incurred by rural and remote residents when accessing specialist treatment can be reduced if a visiting specialist service is available.
authors.affiliation: University Department of Surgery, Sir Charles Gairdiner Hospital, QEII Medical Centre, Nedlands, Western Australia, Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Rankin
authors.forename: W
authors.initials: W
authors.lastname: Hughes-Anderson
authors.forename: A K
authors.initials: AK
authors.lastname: House
authors.forename: D I
authors.initials: DI
authors.lastname: Heath
authors.forename: R J
authors.initials: RJ
authors.lastname: Aitken
authors.forename: J
authors.initials: J
authors.lastname: House
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D003365:Costs and Cost Analysis / Q000191:economics*; D005251:Fees, Medical; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000191:economics*; D012424:Rural Population; D013043:Specialties, Surgical / Q000191:economics*