Integrated health centres could be considered for Queenstown, Gore, Oamaru, Balclutha and the Maniototo.
The initial analysis of hospital capacity in Otago and Southland, prepared for the two district health boards by consultants Cranleigh Health, suggests the need for more integrated care.
In a section of the 107-page report titled "Strategic Themes", the consultants said the separation between primary care and secondary care in small populations was unhelpful.
"It increases costs, and it's often a barrier to better care."
Integrated care models, where all groups involved in health care and local bodies would work together to promote healthy living, could be considered.
The transition to this model would not be easy or quick to implement, and it would "challenge current norms", the report said.
It could potentially involve public/community/private partnerships.
The report also noted that emergency transport systems for both road and air were essential for the successful delivery of rural health services.
Distance, terrain and climate posed particular issues for services to the regions and, at times, the St John Ambulance service struggled to meet the demand.
Return flight times from Queenstown and Dunstan to urban hospitals did not meet the concept of the golden hour "from roadside to bedside".
"It is essential that these two areas can triage and stabilise emergency cases while awaiting retrieval services from Invercargill or Dunedin."
Successfully addressing workforce issues was described as a "critical component" in any future rural healthcare model.
Attention was drawn to the lack of integrated computer systems between healthcare providers.
Information technology would play a critical role in enabling the integration of health services.
This would include remote monitoring and diagnosis, access to electronic medical records, patient booking systems and education for both patients and health professionals, the report said.
Features of the existing service
- Dunstan Hospital has the highest number of hospital discharges per head of population and Queenstown the lowest.
- Oamaru has the largest number of beds (35); Balclutha has the lowest (17).
- Gore has the highest number of emergency department attendances, on a population basis, followed by Oamaru and Queenstown.
- Nearly half the services received by the various rural populations are delivered at Dunedin and Invercargill hospitals.
- Only Central Otago and Oamaru general practitioners offer a comprehensive 24-hour service.
