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Rural and urban general practice: a comparison in 34 countries


 
 
 Rural areas have problems in attracting and retaining primary care workforce. Comparable problems but with a different background occur in deprived urban areas. Here we focus on primary care practices that do work in rural areas and not on the shortage or lack of access for the rural population. We answer the question whether these practices have a different organisation, lack resources and have different service profiles, compared to practices in semi-rural and urban areas.
 
 
 
 We used data from the QUALICOPC study, conducted among approximately 7,000 GPs in 34 (mainly European) countries, on the organisation of practices, their human resources and equipment and their service profiles. Data were analysed using multilevel regression analysis, with countries and GPs as levels.
 
 
 
 In general the practices in rural areas are more often single-handed and have less other primary care workers available. In most countries they have more equipment and their service profiles are broader, in particular as compared to inner-city urban practices.
 
 
 
 The combination of increasing demand for care and undersupply of health care services can lead to a primary care shortage in rural areas. However, the practices that are currently located in rural area in most countries seem to be able to cope with the situation by providing a broader range of services, compared to service-rich urban areas. Against growing health needs of an ageing and often poorer population, there is a risk of lack of facilities and equipment and ageing staff. Until now this is not manifest in the primary care practices in most countries.
