Aust. J. Rural Health (2005) 13, 348–352 © 2005 National Rural Health Alliance Inc. Blackwell Science, LtdOxford, UKAJRAustralian Journal of Rural Health1038-52822005 National Rural Health Alliance Inc. 2005136348352Original ArticleHACC SERVICES IN RURAL VICTORIAB. M. WARD Et al. Correspondence: Bernadette M. Ward, School of Public Health, Faculty of Health Sciences, La Trobe University, Bendigo, PO Box 199, Bendigo, Victoria, 3552, Australia. Email: b.ward@latrobe.edu.au Accepted for publication June 2005. Original Article Patterns of home and community care service delivery to culturally and linguistically diverse residents of rural Victoria Bernadette M. Ward, Karen S. Anderson and Maria S. Sheldon School of Public Health, La Trobe University, Bendigo, Victoria, Australia Abstract Objective: To describe and compare patterns of Home and Community Care (HACC) utilisation among cul- turally and linguistically diverse (CALD) people and Australian-born residents of rural Victoria. Design: The HACC Minimum Data Set provides infor- mation regarding levels of service provision and cover- age in Victoria. Data from January to June 2002 were analysed to provide a profile of client characteristics and service usage in rural Victoria. Patterns of service utili- sation were compared with the profile of the CALD population in the 2001 Census. Results: The proportion of CALD residents who are HACC clients is consistent with demographic profiles. However, their extent of service usage is not consistent with patterns of use by Australian-born residents. HACC clients born in non-English-speaking countries, receive 35% less hours of HACC service than their Australian-born counterparts. HACC clients born over- seas in English-speaking countries receive nine per cent less hours of HACC service than the Australian-born group (F = 8.9, P = 0.00). Both groups of overseas-born clients use a smaller range of HACC services (F = 1.9, P = 0.16). Conclusion: Planners and service providers need to monitor levels of HACC service delivery among popu- lation groups to ensure that CALD population groups receive equitable levels of HACC services. The HACC Minimum Data Set is one source of data that can assist in this process. KEY WORDS: access, aged, culturally and linguistically diverse, disabled, home and community care, rural. Introduction People in rural and remote communities experience more illness and poor health than metropolitan popula- tions and these inequalities are further exacerbated by poor access to health care services and inequities in the distribution of aged care resources. 1–3 While many rural communities face issues of geographical isolation and a lack of access to specialist services, these issues are intensified for culturally and linguistically diverse (CALD) populations as services in regional Australia are inadequately servicing the needs of CALD groups. 4 There is a disproportionately low use of country health services by CALD people because of language barriers, social isolation and unfamiliarity with prevention ser- vices. 5 Poor access, by all client groups, to Home and Community Care (HACC) services is exacerbated by limited access to transport. 6 Australia’s population is ageing. In 2001, the propor- tion of people aged 65 years and over was 12.6%. 7 Nationally, population projections indicate that older (aged 65 years and over) Australians from countries where English is not the first language will comprise approximately one quarter of the total population by the year 2011. 8 This population group is projected to increase and age more rapidly than the Australian-born older population. 7 By 2011, Victoria is projected to be have the most diverse older population of any state or territory in Australia, with 30% of people aged 65 years or over being immigrants from countries where English is not the main language. 8 In 2001, eight per cent (21 354) of the population of the Loddon Mallee Region (LMR) were born overseas. Those born in England were the largest proportion of overseas-born residents in all local government areas. 7 Aside from England, the other highest ranking countries of overseas born were New Zealand, Scotland, the Netherlands, Germany, Italy, South Africa, Greece, Philippines and Turkey. 7 The HACC program aims to provide a range of flex- ible services that assist aged, frail and disabled people,