title: Travelling to the city for hospital care: access factors in country Aboriginal patient journeys.
abstract: OBJECTIVE
  This study described the challenges for rural and remote Aboriginal people requiring transport to city hospitals for tertiary care.
  
  
  METHODS
  Semi-structured qualitative interviews.
  
  
  METHODS
  South Australian rural and remote health services and tertiary hospitals.
  
  
  METHODS
  Twenty-eight urban health professionals from six hospitals and 32 health professionals from four rural and remote regions were interviewed. Twelve patients, three carers, four people responding as patient and carers, and one patient and carer couple were also interviewed, with eight elder women meeting as a focus group.
  
  
  METHODS
  The study identified specific structural barriers in urban health services or policy that prevented rural and remote Indigenous patients from receiving optimum care.
  
  
  RESULTS
  Problems accessing transport were identified as the most significant factor affecting access to care by the majority of patients and staff. They reported that travel to an urban hospital was costly, and coordination of travel with care was poor. A further problem was travelling while unwell.
  
  
  CONCLUSIONS
  Travelling to a city hospital is a significant barrier for rural and remote Indigenous patients. Arranging and supporting travel is a time-consuming work that is not recognised by the health care system.
authors.affiliation: Health Care Management, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Kelly
authors.forename: Judith
authors.initials: J
authors.lastname: Dwyer
authors.forename: Eileen
authors.initials: E
authors.lastname: Willis
authors.forename: Brita
authors.initials: B
authors.lastname: Pekarsky
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D036301:Qualitative Research; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013021:South Australia; D014195:Travel; D019037:Urban Health Services / Q000706:statistics & numerical data*
keywords: Aboriginal health; Indigenous health; health services access; patient issues; remote health delivery