Abstract:

In Australia, 28% of the population live in remote and rural areas, where they face many health service utilization challenges due to geographical conditions, and generally have lower health status than those living in coastal metropolitan areas. To address the challenges of accessing health services in remote and rural areas, the Australian Government Department of Health and Aged Care has introduced a geographical classification system to help healthcare providers to improve healthcare services since 1994, and regularly updated the system to adapt to the latest sociodemographic and healthcare status, as well as formulated a range of complementary health policies to support rural and remote areas. From 2018, Australian Government Department of Health and Aged Care has adopted a new classification standard, the Modified Monash Model. We reviewed Australia's practices and concluded that, to better deliver high-quality and accessible healthcare services to areas with weak healthcare resources in China, Australia's experience could be used for reference, during taking actions to promote and refine the geographic classification system for healthcare services in a timely manner, formulating policies supporting the enhancement of access to health workers systematically, and taking advantage of modern, high and new technologies.

Key words: Rural and remote areas, Rural health, Resource allocation, Geographical classification, Health services accessibility, Health equity, Health policy, Australia

摘要：

澳大利亚28%的人口居住在农村或偏远地区，因为地理条件问题，该类人群在卫生服务利用上面临着诸多挑战，健康状况普遍劣于沿海大都市区居民。为解决该类地区的医疗服务难题，澳大利亚卫生部自1994年起使用基于地理分级的人力资源分类系统以改进医疗服务，并定时更新地理分级系统以适应新的社会人口情况与医疗服务状况，同时制定了一系列配套的卫生政策来支持农村及偏远地区的医疗服务。2018年起，澳大利亚卫生部开始启用新的分级标准，即改良版蒙纳士模型（MMM）。本文回顾性分析了澳大利亚的做法并认为：为更好地为我国医疗资源薄弱地区提供优质、可及的医疗服务，我国可借鉴澳大利亚的相关经验，适时推进并分阶段细化医疗服务的地理分级系统，系统化制定相应资源优化政策，并发挥现代化与高新科学技术的作用。

关键词: 农村和边远地区, 农村卫生, 资源配置, 地理分级, 卫生服务易得程度, 健康公平, 卫生政策, 澳大利亚