Variation by remoteness area
Rural and remote Australians face unique challenges due to their geographic location and often have poorer health outcomes than people living in metropolitan areas (AIHW 2018, 2023). Health and aged care service availability, location, cost and cultural safety have an impact on whether people living with dementia can access the care they need in a timely manner (AIHW 2020; AIHW 2023; Nolan-Isles et al. 2021).
Compared with people in metropolitan areas, people living in rural and remote areas often have:
- reduced access to specialists (AIHW 2022) who primarily diagnose the type of dementia and initially prescribe dementia-specific and other medications
- reduced access to GPs (AIHW 2022), with the associated use of locum doctors who are less likely to have an ongoing relationship with patients
- reduced access to diagnostic services such as MRIs (NHSD 2023)
- symptoms of dementia for a longer period of time before seeking healthcare advice and/or receiving a diagnosis (Bryant et al. 2021; Greenway-Crombie et al. 2012). This delayed diagnosis may occur after the early stages of dementia, when dementia-specific medications are most beneficial
- higher rates of cardiovascular disease, diabetes and other risk factors for dementia (AIHW 2021)
- different hospital admitting rights and a broader use of hospital services (such as for respite care).
This page presents a summary of geographical variation in the use of health services and residential respite care among people living with dementia by remoteness area.
As health service use changes after a person enters permanent residential aged care, results are shown by whether people living with dementia were living in the community or living in permanent residential aged care.
See the Technical guide for more information on the study cohorts, geographies and services examined.
Very Remote and Remote areas of Australia have the highest proportion of Aboriginal and Torres Strait Islander (First Nations) people (41% and 15%, respectively (ABS 2021), however, the number of First Nations people identified in the dementia study cohort was too small to allow separate analysis. For further information, see Understanding dementia among First Nations people.
ABS (Australian Bureau of Statistics) (2021), Census of Population and Housing - Counts of Aboriginal and Torres Strait Islander Australians, ABS Website, accessed 24 August 2023.
AIHW (Australian Institute of Health and Welfare) (2018) Survey of Health Care: selected findings for rural and remote Australians, AIHW, Australian Government, accessed 25 May 2023.
AIHW (2020) Coordination of health care: experiences of barriers to accessing health services among patients aged 45 and over, AIHW, Australian Government, accessed 27 June 2023.
AIHW (2021) Geographical variation in disease: diabetes, cardiovascular and chronic kidney disease, AIHW, Australian Government, accessed 17 August 2023.
AIHW (2022) Health workforce, AIHW, Australian Government, accessed 25 May 2023.
AIHW (2023) Rural and remote health, AIHW, Australian Government, accessed 12 September 2023.
Bryant J, Noble N, Freund M, Rumbel J, Eades S, Sanson-Fisher R, Lowe M, Walsh J, Piterman L, Koch S, Meyer C, Todd E (2021) ‘How can dementia diagnosis and care for Aboriginal and Torres Strait Islander people be improved? Perspectives of healthcare providers providing care in Aboriginal community controlled health services’, BMC Health Services Research, 21:699,
Greenway-Crombie A, Snow P, Disler P, Davis S, Pond D (2012) ‘Influence of rurality on diagnosing dementia in Australian general practice’, Australian Journal of Primary Health 18(3):178-184, doi:10.1071/PY12008.
NHSD (National Health Services Directory) (2023), Healthdirect Australia, Australian Government, accessed 17 August 2023.
Nolan-Isles D, Macniven R, Hunter K, Gwynn J, Lincoln M, Moir R, Dimitropoulos Y, Taylor D, Agius T, Finlayson H, Martin R, Ward K, Tobin S, Gwynne K (2021) ‘Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia’, International Journal of Environmental Research and Public Health, 18(6):3014, doi: 10.3390/ijerph18063014.