Socioeconomic disadvantage and the practice location of recently Fellowed Australian GPs: a cross-sectional analysis
Dominica Moad A B , Alison Fielding A B , Amanda Tapley A B , Mieke L. van Driel C , Elizabeth G. Holliday A , Jean I. Ball D , Andrew R. Davey A B , Kristen FitzGerald E F , Michael Bentley F , Neil A. Spike G H I , Catherine Kirby I , Allison Turnock E J and Parker Magin A B KA The University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia.
B GP Synergy, NSW & ACT Research and Evaluation Unit, Level 1, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.
C The University of Queensland, Faculty of Medicine, Primary Care Clinical Unit, 288 Herston Road, Herston, Qld 4006, Australia.
D Hunter Medical Research Institute, Clinical Research Design and Statistical Support Unit, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
E University of Tasmania, School of Medicine, Level 1, Medical Science 1, 17 Liverpool Street, Hobart, Tas. 7000, Australia.
F General Practice Training Tasmania, Level 3, RACT House, 179 Murray Street, Hobart, Tas. 7000, Australia.
G The University of Melbourne, Department of General Practice and Primary Health Care, 200 Berkeley Street Carlton, Vic. 3053, Australia.
H Monash University, Department of General Practice and Primary Health Care, 1/270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
I Eastern Victoria General Practice Training, 15 Cato Street, Hawthorn, Vic. 3122, Australia.
J Department of Health, Level 3, 200 Collins Street, Hobart, Tas. 7000, Australia.
K Corresponding author. Email: parker.magin@newcastle.edu.au
Australian Journal of Primary Health 28(2) 104-109 https://doi.org/10.1071/PY21179
Submitted: 27 July 2021 Accepted: 22 November 2021 Published: 23 February 2022
Abstract
Background: Socioeconomic disadvantage and the ‘inverse care law’ have significant effects on the health and well-being of Australians. Early career GPs can help address the needs of socioeconomically disadvantaged communities by choosing to practice in these locations. This study addressed an evidence gap around GPs post-Fellowship (within 2 years) practice location, and whether practice location is related to postgraduate vocational training. Methods: This was a cross-sectional questionnaire-based study of recently Fellowed GPs from New South Wales, the Australian Capital Territory, Victoria and Tasmania. Questionnaire items elicited information about participants’ current practice, including location. Where consent was provided, participants’ questionnaire responses were linked to previously collected vocational GP training data. The outcome factor in analyses was practice location socioeconomic status (SES): the four deciles of greater socioeconomic disadvantage versus locations with a higher SES. SES was classified according to the Socio-Economic Indexes for Areas – Index of Relative Socioeconomic Disadvantage. Multivariable logistic regression was undertaken. Results: Of participants currently working in clinical general practice, 26% were practicing in the four deciles of greater socioeconomic disadvantage. Significant multivariable associations of working in these locations included having trained in a practice located in an area of greater socioeconomic disadvantage (odds ratio (OR) 3.14), and having worked at their current practice during vocational training (OR 2.99). Conclusion: Given the association of training and practice location for recently Fellowed GPs, policies focused on training location may help in addressing ongoing workforce issues faced by areas of higher socioeconomic disadvantage.
Keywords: family practice, health accessibility, health equity.
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