Patient affiliation with GPs in Australia—Who is and who is not and does it matter?

McRae, Ian; Yen, Laurann; Gillespie, James; Douglas, Kirsty

doi:10.1016/j.healthpol.2010.09.002

Cited by 24 publications

(29 citation statements)

References 11 publications

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“…Preference for a practitioner is very important in the decision to access healthcare and may explain why most Australians are affiliated with an individual GP or GP practice. 26 It may also explain why many rural Australians pay more and travel further to utilise a service other than the local one, or sometimes forego or delay seeking care. Inevitably this results in avoidable higher costs of secondary care (which could have been avoided with early intervention) and higher levels of morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?

Ward¹,

Humphreys²,

McGrail³

et al. 2015

Aust. Health Review

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Objective. Access to primary healthcare (PHC) services is key to improving health outcomes in rural areas. Unfortunately, little is known about which aspect of access is most important. The objective of this study was to determine the relative importance of different dimensions of access in the decisions of rural Australians to utilise PHC provided by general practitioners (GP).Methods. Data were collected from residents of five communities located in 'closely' settled and 'sparsely' settled rural regions. A paired-comparison methodology was used to quantify the relative importance of availability, distance, affordability (cost) and acceptability (preference) in relation to respondents' decisions to utilise a GP service for nonemergency care.Results. Consumers reported that preference for a GP and GP availability are far more important than distance to and cost of the service when deciding to visit a GP for non-emergency care. Important differences in rankings emerged by geographic context, gender and age.Conclusions. Understanding how different dimensions of access influence the utilisation of PHC services is critical in planning the provision of PHC services. This study reports how consumers 'trade-off' the different dimensions of access when accessing GP care in rural Australia. The results show that ensuring 'good' access requires that policymakers and planners should consider other dimensions of access to services besides geography.What is known about the topic? Research indicates that poorer 'access' to GPs, an impediment to seeking primary care at times of need, is the most important factor distinguishing rural from urban health service utilisation behaviour, which undoubtedly contributes to the poorer health outcomes characterising rural and remote populations. Much of the policy on access to date has focussed on increasing the number of GP located in rural and remote areas that are characterised by acute medical workforce shortages. What does this paper add? This study provides empirical data to show how different dimensions of access influence rural Australians' decisions to utilise a GP service. Overall, rural Australians rank preference for a GP as the most important factor in their decision to visit a doctor for a non-emergency consultation. Important differences in rankings emerged by geographic context, gender and age. Distance to a GP service ranks consistently as the third most important access factor and cost is rated the least important aspect of access. What are the implications for practitioners? Although current rural health policies and incentives should continue to target the need to increase the availability of GP in non-metropolitan areas, this alone may not be sufficient to improve GP service utilisation. Other dimensions of access, particularly consumer preference, which are amenable to interventions both nationally and locally, are equally important.

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Section: Discussionmentioning

confidence: 99%

Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?

Ward¹,

Humphreys²,

McGrail³

et al. 2015

Aust. Health Review

View full text Add to dashboard Cite

show abstract

“…We may have underestimated retesting rates if patients received a retest at another service, particularly given young people are less likely to have a regular GP,38 or may have overestimated retesting rates if patients did not pursue retesting following a retest request. Our analysis is based on 25 sites, so our results may not be generalisable to all Australian GP clinics, and site participation may be biased towards clinicians with a higher than typical awareness of sexual health and evidence-based guidelines.…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities—low levels of chlamydia retesting at Australian general practices, 2008–2009

et al. 2012

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“…2) to 75%. 3 In Australia, nearly 90% of adults report affiliation with a primary care physician/general practitioner (GP) or practice 4 and over 90% of people attend a GP at least once every year. 5 Despite this, barriers to the diagnosis and management of hypertension in primary care exist.…”

Section: Introductionmentioning

confidence: 99%

Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample

et al. 2012

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Identifying barriers to hypertension management may facilitate cardiovascular risk reduction. Therefore, our objective, was to determine the prevalence of hypertension not managed with medication ('untreated') in a representative adult sample and identify patient factors/beliefs, and aspects of the patient-general practitioner (GP) relationship associated with untreated hypertension. The North West Adelaide Health Study, a biomedical cohort study over three stages from 2000-2009, assesses hypertension (systolic > or =140 mm Hg and/or > or =90 mm Hg or current treatment with anti-hypertensive medication), chronic disease and associated risk factors and health-care experiences, including risk perception, decision-making preferences, GP/primary care provider affiliation and satisfaction with care (n=2425). The prevalence of hypertension was 32.1% (n=781) comprised of treated (19.0%, n=462) and untreated (13.1%, n=319) hypertension. Thus, 40.8% of hypertension was untreated. Among hypertensive subjects, non-treatment was significantly associated with male sex, age <45 years, workforce participation, infrequent GP visits, dissatisfaction with recent medical care, high total cholesterol, moderate-level physical activity and lower body weights. Compared with participants without hypertension (and no treatment), untreated subjects demonstrated significant (15%) 10-year Framingham general cardiovascular risk (odds ratio=6.44, 95% confidence interval=4.52-9.17). Novel screening strategies and public health messages to address beliefs and perceptions of both patients and the health system are required to identify untreated, at-risk hypertensive individuals.

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Patient affiliation with GPs in Australia—Who is and who is not and does it matter?

Cited by 24 publications

References 11 publications

Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?

Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?

Missed opportunities—low levels of chlamydia retesting at Australian general practices, 2008–2009

Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample

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