An investigation of equity of rural speech-language pathology services for children: A geographic perspective

Abstract

The World Health Organization's equity objective states that there should be equal access to healthcare for equal need, regardless of location. Disparities between health services and challenges to achieving the equity objective have been documented both in Australia and around the world. However, little is known about the extent to which this objective has been met in the field of speech-language pathology in Australia. This study used structured interviews with 74 speech-language pathologists working in rural areas of New South Wales and Victoria. The data obtained were used to develop maps to describe the availability of paediatric speech-language pathology services through consideration of location and frequency. The findings show that 98.60% of localities are unserviced at the ideal frequency of weekly or more often. It is important to note that these percentages include all localities in the represented rural areas of New South Wales and Victoria, some of which are minimally populated. The maps also depict travel and distance as barriers to the accessibility of services and have been used to suggest a critical maximum distance for paediatric outpatient speech-language pathology services in rural New South Wales and Victoria. From the data collected, 50 kilometres was suggested as the critical maximum distance past which consumers become unable or unwilling to travel to access weekly rural speech-language pathology services in rural New South Wales and Victoria. Thus, people living in almost one third of rural localities in rural New South Wales and Victoria lie beyond what is considered by rural speech-language pathologists to be a reasonable travel distance to weekly speech-language pathology services. These results highlight barriers to the achievement of equitable services in rural areas. The results also provide an essential foundation to inform policy development and assist health service planning to meet the needs of rural consumers.

Changing practice: Implications of the World Report on Disability for responding to communication disability in under-served populations

“…Those living in rural or remote regions have less access to speechlanguage pathology services than their urban-based counterparts (Graham & Cameron, 2008;Verdon et al, 2011). Economic models of healthcare based on a non-universal healthcare policy 6 restrict access to services for people with fewer economic means (Benedict, 2005) and minority groups, transient, migrant, and indigenous populations continue to have unmet need for services (Ou et al, 2011;Stow & Dodd, 2003;Winter, 2001) and experience poorer health and educational outcomes (Elwan, 1999;World Health Organization and the World Bank, 2011).…”

Mapping speech pathology services to developmentally vulnerable and at-risk communities using the Australian Early Development Census

“…For services such as speech-language pathology, this is not always the case McLeod, Press & Phelan, 2010;O'Callaghan, McAllister, & Wilson, 2005;Verdon, Wilson, Smith-Tamaray, & McAllister, 2011;Wilson, Lincoln, & Onslow, 2002).…”

“…Researchers have suggested the maximum distance that consumers are willing to travel to access services is 50 kilometres for weekly services (Verdon et al, 2011) or 65 kilometres for fortnightly services (Wilson et al, 2002). Over one third of communities in non-metropolitan NSW and Victoria are greater than 50 kilometres from a speech-language pathology service (Verdon, et al, 2011), and thus people living in those communities might be unable/unwilling to access a sufficient amount of speechlanguage pathology input. This issue is likely to have an equal, if not greater, effect in other states and territories of Australia, where communities are more widely dispersed.…”

“…Larger scale studies, such as those involving population level surveys, reduce the possible impact of methodological issues common to smaller studies, such as recruitment bias and sampling.In The use of a mapping system f to analyse the data was selected to address the recommendations made by the Australian Government Senate Inquiry and because of its previous use in identifying areas of speech-language pathology service prevision and unmet need for other populations including those in rural and remote areas, and those from CALD backgrounds (see Verdon et al, 2011;Verdon et al, 2014).…”

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

“…teacher aides), however, these models usually involve some degree of inperson contact, usually for assessment and reviews. Unfortunately, a traditional model of service delivery is out of reach for many children, and studies have found poor availability and accessibility of paediatric services in Australia, despite the range of settings and locations in which SLPs practice (17,(112)(113)(114)(115)(116)(117).…”