Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Predicting general practitioner utilisation at a small area level across Western Australia

Greg Lyle A B and Delia Hendrie A
+ Author Affiliations
- Author Affiliations

A School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia.

B Corresponding author. Email: greg.lyle@curtin.edu.au

Australian Journal of Primary Health 25(6) 570-576 https://doi.org/10.1071/PY19084
Submitted: 17 April 2019  Accepted: 26 July 2019   Published: 21 November 2019

Abstract

Equitable delivery of GP services is a key goal in universal healthcare systems. In Australia, information to evaluate equitable delivery is limited, especially at finer geographic scales, leaving an information void that needs to be filled to inform, prioritise and target interventions. To fill this void, GP utilisation was estimated by combining responses on GP utilisation from a national survey differentiated by demographic and area-based socioeconomic and remoteness characteristics with similar characteristics represented geographically at a fine scale. These estimates were then compared to actual GP utilisation to evaluate their predictive reliability. Comparable estimates were found in the greater metropolitan area, with 76% of areas having estimated GP utilisation within ±10% of actual utilisation. Larger discrepancies were found as areas became remoter, with 84% of areas reporting estimated utilisation that was higher than actual utilisation. Comparing the geographic differences between estimated and actual utilisation allowed us to examine the reliability of our methodology. Given the identified limitations, a proxy for GP utilisation at a small area level can be created, a dataset that is not currently published at this geography. This approach has the potential to be applied Australia-wide, providing another valuable tool to evaluate the equitable delivery of primary health care nationally.

Additional keywords: equity, Medical Benefits Scheme, spatial variation.


References

Achat HM, Thomas P, Close GR, Moerkerken LR, Harris MF (2010) General health care service utilisation: where, when and by whom in a socioeconomically disadvantaged population. Australian Journal of Primary Health 16, 132–140.
General health care service utilisation: where, when and by whom in a socioeconomically disadvantaged population.Crossref | GoogleScholarGoogle Scholar | 21128574PubMed |

Australian Health Ministers’ Advisory Council (2017) Aboriginal and Torres Strait Islander Health Performance Framework 2017 report. Department of the Prime Minister and Cabinet, Canberra, ACT, Australia.

Australian Institute of Health and Welfare (2014) Access to primary health care relative to need for Indigenous Australians. Cat. no. AIHW 128. Australian Institute of Health and Welfare, Canberra, ACT, Australia.

Asthana S, Gibson A (2008) Deprivation, demography, and the distribution of general practice: challenging the conventional wisdom of inverse care. The British Journal of General Practice 58, 720–728.
Deprivation, demography, and the distribution of general practice: challenging the conventional wisdom of inverse care.Crossref | GoogleScholarGoogle Scholar | 18826784PubMed |

Bauer J, Brueggmann D, Ohlendorf D, Groneberg DA (2016) General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status. BMC Health Services Research 16, 672
General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status.Crossref | GoogleScholarGoogle Scholar | 27884186PubMed |

Bauer J, Muller R, Bruggmann D, Groneberg DA (2018) Spatial accessibility of primary care in England: a cross-sectional study using a floating catchment area method. Health Services Research 53, 1957–1978.
Spatial accessibility of primary care in England: a cross-sectional study using a floating catchment area method.Crossref | GoogleScholarGoogle Scholar | 28685827PubMed |

Campbell MA, Hunt J, Scrimgeour DJ, Davey M, Jones V (2018) Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review. Australian Health Review 42, 218–226.
Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review.Crossref | GoogleScholarGoogle Scholar | 28263705PubMed |

Department of Health (2019) MBS Data by ABS SA3. (Australian Government, Department of Health: Canberra, ACT, Australia) Available at https://www.health.gov.au/internet/main/publishing.nsf/Content/MBS_Data_by_ABS_SA3 [Verified 4 July 2019]

Dewulf B, Neutens T, De Weerdt Y, Van de Weghe N (2013) Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas. BMC Family Practice 14, 122
Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas.Crossref | GoogleScholarGoogle Scholar | 23964751PubMed |

Dudko Y, Robey DE, Kruger E, Tennant M (2018) Selecting a location for a primary healthcare facility: combining a mathematical approach with a Geographic Information System to rank areas of relative need. Australian Journal of Primary Health 24, 130–134.
Selecting a location for a primary healthcare facility: combining a mathematical approach with a Geographic Information System to rank areas of relative need.Crossref | GoogleScholarGoogle Scholar | 30064615PubMed |

Evans R, Larkins S, Cheffins T, Fleming R, Johnston K, Tennant M (2017) Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland. Australian Journal of Primary Health 23, 114–122.
Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland.Crossref | GoogleScholarGoogle Scholar | 27531704PubMed |

Golenko XA, Shibl R, Scuffham PA, Cameron CM (2015) Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study. Australian Health Review 39, 136–145.
Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study.Crossref | GoogleScholarGoogle Scholar | 25529389PubMed |

McGrail MR, Humphreys JS (2009) The index of rural access: an innovative integrated approach for measuring primary care access. BMC Health Services Research 9, 124
The index of rural access: an innovative integrated approach for measuring primary care access.Crossref | GoogleScholarGoogle Scholar | 19624859PubMed |

McGrail MR, Humphreys JS (2015) Spatial access disparities to primary health care in rural and remote Australia. Geospatial Health 10, 358
Spatial access disparities to primary health care in rural and remote Australia.Crossref | GoogleScholarGoogle Scholar | 26618314PubMed |

Ou L, Chen J, Hillman K (2017) Socio-demographic disparities in the utilisation of general practice services for Australian children – results from a nationally representative longitudinal study. PLoS One 12, e0176563
Socio-demographic disparities in the utilisation of general practice services for Australian children – results from a nationally representative longitudinal study.Crossref | GoogleScholarGoogle Scholar | 28448555PubMed |

Page N, Langford M, Higgs G (2018) An evaluation of alternative measures of accessibility for investigating potential ‘deprivation amplification’ in service provision. Applied Geography (Sevenoaks, England) 95, 19–33.
An evaluation of alternative measures of accessibility for investigating potential ‘deprivation amplification’ in service provision.Crossref | GoogleScholarGoogle Scholar |

Public Health Information Development Unit (2017) Statistical Local Area 2011 Medical Benefits Scheme Services. (Australian Urban Research Infrastructure Network, AURIN, The University of Melbourne: Melbourne, Vic., Australia) Available at https://data.aurin.org.au/dataset/tua-phidu-sla11-mbsservices-sla2011 [Verified 19 June 2017]

Roeger LS, Reed RL, Smith BP (2010) Equity of access in the spatial distribution of GPs within an Australian metropolitan city. Australian Journal of Primary Health 16, 284–290.
Equity of access in the spatial distribution of GPs within an Australian metropolitan city.Crossref | GoogleScholarGoogle Scholar | 21138695PubMed |

Turrell G, Oldenburg BF, Harris E, Jolley D (2004) Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness. Australian and New Zealand Journal of Public Health 28, 152–158.
Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness.Crossref | GoogleScholarGoogle Scholar | 15233355PubMed |

Wang Y, Hunt K, Nazareth I, Freemantle N, Petersen I (2013) Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open 3, e003320
Do men consult less than women? An analysis of routinely collected UK general practice data.Crossref | GoogleScholarGoogle Scholar | 24334199PubMed |

Wilkinson D, Symon B (2000) Inequitable distribution of general practitioners in Australia: estimating need through the Robin Hood Index. Australian and New Zealand Journal of Public Health 24, 71–75.
Inequitable distribution of general practitioners in Australia: estimating need through the Robin Hood Index.Crossref | GoogleScholarGoogle Scholar | 10777982PubMed |