OBJECTIVE: To compare the rate of provision of longer consultations per head of population across practice locations categorised by socioeconomic status. DESIGN: Retrospective analysis of Medicare data for all consultations for all general practitioners in Australia for the 1998-99 and 1999-2000 financial years, grouped by postcode of practice location. Postcodes were categorised by the Socio-Economic Indexes for Areas, Index of Relative Socio-Economic Disadvantage score. MAIN OUTCOME MEASURES: Number of consultations and number of brief, standard, long and prolonged consultations per capita in each postcode grouping. RESULTS: The absolute number of long plus prolonged consultations showed no trend across postcode groups, but the rate ratio per person was significantly higher in more advantaged postcode areas. This represents an example of care provision in inverse relationship to need. DISCUSSION: Despite higher rates of chronic disease and lower rates of preventive care uptake, patients in low socioeconomic status areas receive longer GP consultations at a lower rate than patients in more advantaged areas. Possible strategies to overcome this inverse care provision include increased numbers of GPs in disadvantaged communities, removal of financial disincentives to longer consultations, and strengthening health promotion and community health services in disadvantaged areas.
OBJECTIVE: To compare the rate of provision of longer consultations per head of population across practice locations categorised by socioeconomic status. DESIGN: Retrospective analysis of Medicare data for all consultations for all general practitioners in Australia for the 1998-99 and 1999-2000 financial years, grouped by postcode of practice location. Postcodes were categorised by the Socio-Economic Indexes for Areas, Index of Relative Socio-Economic Disadvantage score. MAIN OUTCOME MEASURES: Number of consultations and number of brief, standard, long and prolonged consultations per capita in each postcode grouping. RESULTS: The absolute number of long plus prolonged consultations showed no trend across postcode groups, but the rate ratio per person was significantly higher in more advantaged postcode areas. This represents an example of care provision in inverse relationship to need. DISCUSSION: Despite higher rates of chronic disease and lower rates of preventive care uptake, patients in low socioeconomic status areas receive longer GP consultations at a lower rate than patients in more advantaged areas. Possible strategies to overcome this inverse care provision include increased numbers of GPs in disadvantaged communities, removal of financial disincentives to longer consultations, and strengthening health promotion and community health services in disadvantaged areas.
Authors: Wen Tang; Blair Grace; Stephen P McDonald; Carmel M Hawley; Sunil V Badve; Neil C Boudville; Fiona G Brown; Philip A Clayton; David W Johnson Journal: Perit Dial Int Date: 2014-02-04 Impact factor: 1.756
Authors: Upali W Jayasinghe; Judith Proudfoot; Christopher A Barton; Cheryl Amoroso; Chris Holton; Gawaine Powell Davies; Justin Beilby; Mark F Harris Journal: Health Qual Life Outcomes Date: 2009-06-03 Impact factor: 3.186
Authors: Elizabeth Jean Comino; Gawaine Powell Davies; Yordanka Krastev; Marion Haas; Bettina Christl; John Furler; Anthony Raymont; Mark F Harris Journal: BMC Health Serv Res Date: 2012-11-21 Impact factor: 2.655
Authors: Mark F Harris; Fakhrul Md Islam; Bin Jalaludin; Jack Chen; Adrian E Bauman; Elizabeth J Comino Journal: BMC Fam Pract Date: 2013-06-16 Impact factor: 2.497