Report finds five-fold variations in accessibility of GP care
Australians are up to five times more likely to avoid seeing a general practitioner (GP) due to cost in some parts of the country compared to others, and there are similar variations in the availability of GP after-hours services.
The first Healthy Communities report from the National Health Performance Authority has found that the percentage of people who say they delayed seeing a GP due to cost in the preceding year varied from 3% in some areas to 15% in others.
Released today, the report, Healthy Communities: Australians' experiences with primary health care in 2010–11, also finds the number of GP after-hours visits per person was five times higher in some areas compared to other areas, even when limiting the comparison to within metropolitan areas (0.71 visits per person compared to 0.14 visits).
The report is the first to enable Australians to see data about patient experiences and GP visits expressed at a local level. It shows that where people live has a noticeable impact on whether they will get care when they need it, within acceptable waiting times, and at a price they can afford. However, no one area does consistently well or poorly against all measures.
The report also shows:
- The percentage of Australians who felt they waited longer than acceptable to get a GP appointment was three times higher in some areas compared to others (28% compared to 8%)
- The percentage of Australians who rated their health as fair or poor was twice as high in some areas compared to other areas (19% compared to 9%)
- The number of visits to a GP per person was three times higher in some areas compared to other areas (7.3 visits per person compared to 2.3 visits).
The report, the first in a regular series of Healthy Communities reports to be released by the National Health Performance Authority, is based on the views of nearly 27,000 Australians, and also reports levels of use of GP care funded through the Medicare Benefits Schedule.
The release of the report marks the first time Australians have been able to see data broken down to the level of Medicare Locals – the new primary health care organisations announced by the Australian Government in 2010 to improve the responsiveness, integration and co-ordination of health care services in local communities. There are 61 Medicare Locals across Australia, each of which is responsible for people living within a defined catchment area.
National Health Performance Authority CEO Dr Diane Watson said the report would help Medicare Locals to understand the health and services used by the people living within their borders, but that the findings also raised many other questions.
"The report shows the experiences patients have with affordability, availability and accessibility of GP care can vary quite markedly, even between Medicare Locals that are similar enough for fair comparisons to be drawn," Dr Watson said.
"While the report shows that some people live in areas with higher rates of GP visits, we don’t yet know if this is appropriate given differences in needs for care, or simply reflects a rich supply of doctors."
"Future work by the Authority will seek to throw more light on the extent to which variation in the use of GP services aligns with patient needs."
To allow fairer comparisons to be drawn, the National Health Performance Authority grouped Medicare Locals into three metropolitan, two regional and two rural peer groups, based on similar remoteness and socioeconomic characteristics.
Most of the data in the report were from 2010–11 and collected before Medicare Locals were set up. As such, it establishes a baseline for each Medicare Local population that will prove useful in coming years to monitor improvements in care. Where possible, results are broken down by still smaller geographical areas and presented for 2011–12.
The National Health Performance Authority was established under the National Health Reform Act 2011 as an independent agency that reports regularly on the comparable performance of health care organisations.
The Authority bases its reports on nearly 50 indicators agreed by the Council of Australian Governments.
A further Healthy Communities report later this year will report on patient experiences with, and use of, a wider range of primary health care services involving GPs as well as other primary health care clinicians.