Access to a range of services, including health care, ranks among the key determinants of health and wellbeing. It varies with both health system supply factors and consumer demand characteristics. For rural populations, access to health services can be restricted for a variety of reasons, contributing to poorer health outcomes compared with metropolitan populations. Access to health care differs between communities, despite commonly being seen as homogenous in terms of lack of service and poor access. This article seeks to examine consumer perceptions of access to health service in four shires in rural Victoria and explore differences between rural areas. These insights may assist health services to reorient their modes of service provision to be more accessible to rural health consumers. A confidential self-administered questionnaire was mailed to randomly selected households in the four shires. A total of 1,271 questionnaires were returned (35 percent response rate) with 75 percent of respondents reporting good access to health care overall. Many factors contributed significantly to the perception of health access; however, these factors were unique to each rural community. The implication of this heterogeneity is that rural health care services must be tailored to promote equitable, quality health care outcomes with attention to local community needs at the core of efforts. Only locally-targeted actions will achieve optimal health service planning and delivery.

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