Healthy Communities: Coordination of health care – experiences with GP care among patients aged 45 and over, 2016 - Report - Ongoing relationships with a usual GP or usual place of care

Healthy Communities: Coordination of health care – experiences with GP care among patients aged 45 and over, 2016

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Ongoing relationships with a usual GP or usual place of care

Key findings

  • Nationally, nearly all patients (98%) had a usual GP or place of care.
  • Patients who were more likely to have a usual GP or place of care were aged 75 or over, lived in Major cities, spoke English, had higher levels of education, were covered by private health insurance, were in poorer health and had more long-term health conditions.
  • Across PHN areas, patients in regional PHNs such as Western Queensland and the Northern Territory were less likely to have both a usual GP and place of care, and more likely to have a usual place of care only. Patients in Perth South were most likely to have both a usual GP and place of care (85%).

Ongoing relationships between patients and their health care providers allow GPs to get to know their patients over time, facilitating personally focused care (Hill & Freeman 2011; Reid et al. 2016). Ongoing relationships also encourage patient trust in professional judgements and advice over time and have been shown to improve the uptake of preventive care, enhanced adherence to treatment and increased satisfaction with care (Gray et al. 2003).

A ‘usual GP’ is the GP whom a person visits for the majority of their health care. A ‘usual place of care’ is the usual place that a person goes to if they are sick or need advice about their health. Examples of a usual place of care include a clinic with GPs only or with GPs and other health professionals, a community health centre or an Aboriginal Medical Service (ABS 2016). A small proportion of patients (1.2%) visited a hospital emergency department as their usual place of care.

The majority of patients surveyed (98%) had either a usual GP or usual place of care, and 8 in 10 patients (80%) had both a usual GP and usual place of care. Each type of ongoing relationship between a patient and a GP or a patient and a practice makes an important contribution to a patient‘s experience of how care is connected over time (Freeman & Hughes 2010).

In the 2016 Survey of Health Care, participants were asked separate questions about whether they had a usual GP, and whether they had a usual place of care.

National results

The survey explored the experiences of people aged 45 and over who had seen a GP in the previous 12 months. Almost all (98%) of these patients reported having either a usual GP or place of care, but proportions varied by sociodemographic variables such as age, socioeconomic group and main language spoken, and by where someone lived. The findings summarised in the sections that follow look at each of these characteristics on their own, and do not examine any interactions or correlations that may exist between them. More detailed data are available in the supplementary data tables associated with this report.

Sex

In 2016, women (98%) were slightly more likely than men (97%) to have a usual GP or place of care.

Age group

Almost all (99%) patients aged 75 and over had a usual GP or usual place of care. This proportion was slightly lower among younger patients—for example, 96% of patients aged 45–54 had a usual GP or usual place of care.

Though having a usual place of care usually means that a patient also has a usual GP, this is not always the case (Figure 2.1). Patients aged 75 and older were more likely to have a usual GP only (12%) compared with 4.9% of patients aged 45–54. One factor that may contribute to older patients having a usual GP only could be if they live in residential care or are otherwise unable to travel to a general practice, and have a mobile GP visit them instead.

Figure 2.1: Use of GP care among patients aged 45 and over, by age group, 2016

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Age (years) No usual GP or place Usual GP only Usual place only Usual GP and place
45–54 4.1% 4.9% 16.4% 74.6%
55–64 2.7% 6.5% 10.7% 80.1%
65–74 1.4% 7.9% 6.4% 84.2%
75+ 0.7% 12.2% 3.5% 83.6%

Remoteness

Patients living in Remote/Very remote areas were less likely than those living in Major cities to have a usual GP or place of care (94% compared with 98%). The primary care settings used to access GP care also differed by remoteness: patients living in Remote/Very remote areas were considerably less likely than patients living in Major cities to have a usual GP, and were more likely to have a usual place only (Figure 2.2).

Figure 2.2: Use of GP care among patients aged 45 and over, by remoteness area, 2016

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Remoteness area No usual GP or place Usual GP only Usual place only Usual GP and place
Major cities 2.4% 7.8% 8.7% 81.1%
Inner regional 2.2% 6.3% 11.0% 80.5%
Outer regional 3.4% 6.8% 15.8% 74.2%
Remote/Very remote 5.6% 7.9% 25.6% 60.5%

Main language spoken

Patients who spoke English at home were more likely to report having a usual GP or place of care than patients who spoke another language (98% compared with 94%). Patients who spoke another language at home were more likely to have a usual GP only compared with those who spoke English (Figure 2.3).

Figure 2.3: Use of GP care among patients aged 45 and over, by main language spoken at home, 2016

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Main language No usual GP or place Usual GP only Usual place only Usual GP and place
English 2.2% 6.3% 10.5% 81.1%
Other language 5.7% 18.2% 6.6% 69.4%

Private health insurance coverage

Patients covered by private health insurance were slightly more likely to have a usual GP or place of care compared with patients who were not covered (98% compared with 97%). Patients not covered by private health insurance were more likely to have a usual GP only (Figure 2.4).

Figure 2.4: Use of GP care among patients aged 45 and over, by private health insurance coverage, 2016

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Private health cover No usual GP or place Usual GP only Usual place only Usual GP and place
Covered by private health insurance 2.1% 5.9% 9.9% 82.0%
Not covered by private health insurance 3.1% 10.0% 10.4% 76.4%

Highest level of educational attainment

Patients who did not go to school were less likely to have both a usual GP and a usual place of care, but more likely to have a usual GP only, compared with patients who had attained higher levels of education (such as a tertiary degree) (Figure 2.5).

Figure 2.5: Use of GP care among patients aged 45 and over, by highest level of educational attainment, 2016

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Highest level of educational attainment No usual GP or place Usual GP only Usual place only Usual GP and place
Bachelor degree or higher 3.0% 4.3% 11.1% 81.7%
Advanced Diploma or Diploma 2.5% 5.5% 10.3% 81.8%
Certificate III/IV (incl. Trade Certificate) 2.2% 6.6% 12.2% 79.1%
Year 12 or equivalent 2.7% 8.7% 9.0% 79.7%
Year 11 or below 2.1% 9.7% 9.0% 79.2%
Did not go to school 6.4% 21.0% 5.3% 67.4%

Self-assessed patient health status

Patients who assessed their health as poor were more likely than those who assessed their health to be excellent to have a usual GP or place of care (99% compared with 96%) (Figure 2.6). Patients who assessed their health as poor were more likely than those who assessed their health to be excellent to have both a usual GP and a usual place of care (85% compared with 76%) and were more likely to have a usual GP only. Those who assessed their health to be excellent were more likely to have a usual place of care only.

Figure 2.6: Use of GP care among patients aged 45 and over, by self-assessed health status, 2016

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Self-assessed health status No usual GP or place Usual GP only Usual place only Usual GP and place
Excellent 4.0% 5.5% 14.7% 75.9%
Very good 2.5% 6.5% 11.6% 79.3%
Good 2.5% 7.5% 9.2% 80.7%
Fair 1.7% 9.8% 6.3% 82.2%
Poor 1.2% 9.4% 4.5% 84.7%

Number of long-term health conditions

Continuity of care and accumulated professional knowledge of individual patients and their health are especially important for patients with chronic and/or multiple conditions, who typically have to use health care services regularly (Pavlič et al. 2015; Reid et al. 2016). In 2016, patients with 3 or more long-term health conditions were more likely to have a usual GP or place of care than those with no long-term health conditions (99% compared with 95%). Patients with no long-term health conditions were more likely than those with long-term health conditions to have a usual place of care only (17% compared with 5.2% of patients with 3 or more long-term health conditions) (Figure 2.7). Patients with 3 or more long-term health conditions were more likely than those with no long-term health conditions to have both a usual GP and place of care (87% compared with 71%).

Figure 2.7: Use of GP care among patients aged 45 and over, by number of long-term health conditions, 2016

Note: For definition of ‘long-term health condition’, see Glossary.

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No. long-term health conditions No usual GP or place Usual GP only Usual place only Usual GP and place
None 5.1% 7.0% 16.5% 71.3%
1 2.5% 7.3% 10.8% 79.3%
2 1.4% 7.6% 8.2% 82.8%
3 or more 0.9% 7.3% 5.2% 86.6%

State and territory results

In 2016, at least 97% of patients had a usual GP or usual place of care across all states and territories other than the Northern Territory—where 92% of patients had a usual GP or place of care. Patients in the Northern Territory accessed primary care differently than in other states and territories: the proportion of patients having a usual place of care only (24%) was almost double that in other states and territories (Figure 2.8).

Figure 2.8: Use of GP care among patients aged 45 and over, by state and territory, 2016

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State or territory No usual GP or place Usual GP only Usual place only Usual GP and place
Australia 2.5% 7.4% 10.1% 80.0%
NSW 2.9% 8.8% 8.9% 79.3%
Vic 2.0% 7.2% 10.8% 80.0%
Qld 2.8% 6.7% 9.9% 80.6%
WA 2.1% 6.9% 9.5% 81.5%
SA 2.1% 4.8% 12.9% 80.5%
Tas 1.5% 7.7% 10.2% 80.7%
ACT 1.6% 5.1% 9.7% 83.2%
NT 8.2% 4.9% 24.0% 62.5%

Results across PHN areas

Across PHN areas in 2016:

  • the proportion of patients with a usual GP or place of care ranged from 99% in Murray (Victoria and part of New South Wales) to 92% in the Northern Territory
  • the proportion of patients with a usual GP ranged from 91% in Perth South to 57% in Western Queensland
  • the proportion of patients with a usual place of care ranged from 94% in Adelaide to 82% in South Western Sydney.

To explore the data for these measures across PHNs in further detail, see Coordination of health care interactive charts.

Variations in primary care settings across PHN areas

The geographical area in which a patient lives affects their access to, and available choice of, provider or place to visit for GP care. Survey results showed that the clear majority of patients across all PHNs had both a usual GP and usual place of care, but that the proportions with only a usual GP or usual place of care varied across PHN areas (Figure 2.9).

Across PHN areas:

  • patients in Perth South were most likely to have both a usual GP and place of care (85%), and patients in Western Queensland were least likely (51%)
  • where patients were least likely to have both a usual GP and usual place of care (Western Queensland and Northern Territory), they were most likely to report having only a usual place of care (37% and 24%, respectively)
  • the proportion of patients who had a usual GP only ranged from 13% in South Western Sydney to 4% in Country South Australia
  • the proportion of patients who had no usual GP or usual place of care was relatively small overall but varied among PHN areas—from 8.2% in the Northern Territory to 1.4% in Murrumbidgee (New South Wales), Hunter New England and Central Coast (New South Wales), and Murray (Victoria and part of New South Wales).

Figure 2.9: Use of GP care among patients aged 45 and over, by PHN area, 2016

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Primary Health Network No usual GP or place Usual GP only Usual place only Usual GP and place
National 2.5% 7.4% 10.1% 80.0%
NSW Central & Eastern Sydney 2.7% 9.7% 8.9% 78.8%
Northern Sydney 3.0% 8.1% 8.3% 80.6%
Western Sydney 4.3% 11.1% 7.0% 76.7%
Nepean Blue Mountains 4.2% 9.1% 8.8% 78.0%
South Western Sydney 6.0% 13.0% 7.3% 74.3%
South Eastern NSW 2.4% 7.5% 8.0% 82.9%
Western NSW 1.8% 7.4% 12.3% 79.1%
Hunter New Eng. & Cent. Coast 1.4% 6.4% 10.5% 81.6%
North Coast 2.3% 7.2% 8.5% 81.8%
Murrumbidgee 1.4% 8.5% 10.5% 79.7%
Vic North Western Melbourne 1.6% 9.7% 10.3% 78.2%
Eastern Melbourne 2.4% 6.2% 9.8% 81.3%
South Eastern Melbourne 1.9% 6.8% 10.1% 81.4%
Gippsland 3.1% 5.1% 19.2% 72.7%
Murray 1.4% 7.0% 14.0% 78.1%
Western Victoria 2.2% 5.8% 9.3% 82.8%
Qld. Brisbane North 3.2% 6.0% 7.4% 83.9%
Brisbane South 1.9% 7.6% 7.9% 83.1%
Gold Coast 2.6% 5.7% 9.0% 82.6%
Darling Downs & West Moreton 1.5% 7.2% 12.3% 78.5%
Western Queensland 4.9% 5.8% 37.4% 51.0%
Central Qld, Wide Bay & Sunshine Coast 3.1% 6.9% 7.8% 81.9%
Northern Queensland 4.5% 5.9% 16.2% 73.6%
SA Adelaide 1.8% 5.1% 10.1% 83.1%
Country SA 2.4% 4.4% 18.2% 74.8%
WA Perth North 2.0% 7.2% 10.0% 81.5%
Perth South 1.9% 6.2% 7.1% 84.6%
Country WA 3.3% 7.4% 12.6% 76.5%
Tas. Tasmania 1.5% 7.7% 10.2% 80.7%
NT Northern Territory 8.2% 4.9% 24.0% 62.5%
ACT Australian Capital Territory 1.6% 5.1% 9.7% 83.2%

Notes

  1. These data are based on survey responses from adults aged 45 and over who had seen a GP in the 12 months before survey selection (November 2014 to November 2015).
  2. Patients counted in ‘usual GP only’ also include those who answered ‘yes’ to having a usual GP but did not respond to the survey question asking whether or not they had a usual place of care.

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