Are changes in Australian national primary healthcare policy likely to promote or impede equity of access? A narrative review
Matthew Fisher A B E , Fran Baum A B , Adrian Kay B C and Sharon Friel B D
+ Author Affiliations
- Author Affiliations
A Southgate Institute for Health, Society and Equity, Health Sciences building, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
B NHMRC Centre of Research Excellence in the Social Determinants of Health Equity, c/o Southgate Institute for Health, Society and Equity, GPO Box 2100, Adelaide, SA 5001, Australia.
C Crawford School of Public Policy, Australian National University, Acton, ACT 2601, Australia.
D School of Regulation and Global Governance, Australian National University, Acton, ACT 2601, Australia.
E Corresponding author. Email: matt.fisher@flinders.edu.au
Australian Journal of Primary Health 23(3) 209-215 https://doi.org/10.1071/PY16152
Submitted: 24 November 2016 Accepted: 15 March 2017 Published: 6 June 2017
Abstract
Significant changes have occurred in Australia’s national primary healthcare (PHC) policy over the last decade, but little assessment has been made of implications for equity. This research aimed to identify key recent changes in national PHC policy and assess implications for equity of access to PHC. Academic literature was reviewed to identify issues affecting equity of access in national PHC policy, and grey literature was also reviewed to identify significant policy changes during 2005–16 with implications for equitable access. Equity implications of four areas of policy change, set against the existing Medicare system, were assessed. It was found that Medicare supports equitable access to general practice, but there is a risk of reduced equity under current policy settings. Four changes in PHC policy were selected as having particular implications for equity of access and these were assessed as follows: increased involvement of private health insurance presents risks for equity; equity implications of new models of coordinated care are unclear; and regional primary health organisations and current policy on Aboriginal and Torres Strait Islander health have potential equity benefits, but these will depend on further implementation.
Additional keywords: healthcare disparities, healthcare reform.
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