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Swami M, Gravelle H, Scott A, Williams J. Hours worked by general practitioners and waiting times for primary care. HEALTH ECONOMICS 2018; 27:1513-1532. [PMID: 29920838 DOI: 10.1002/hec.3782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 03/25/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
The decline in the working hours of general practitioners (GPs) is a key factor influencing access to health care in many countries. We investigate the effect of changes in hours worked by GPs on waiting times in primary care using the Medicine in Australia: Balancing Employment and Life longitudinal survey of Australian doctors. We estimate GP fixed effects models for waiting time and use family circumstances to instrument for GP's hours worked. We find that a 10% reduction in hours worked increases average patient waiting time by 12%. Our findings highlight the importance of GPs' labor supply at the intensive margin in determining the length of time patients must wait to see their doctor.
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Affiliation(s)
- Megha Swami
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Parkville, Victoria, Australia
- Department of Economics, University of Melbourne, Parkville, Victoria, Australia
| | - Hugh Gravelle
- Centre for Health Economics, University of York, York, UK
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Parkville, Victoria, Australia
| | - Jenny Williams
- Department of Economics, University of Melbourne, Parkville, Victoria, Australia
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Hamiduzzaman M, De Bellis A, Abigail W, Kalaitzidis E. The Social Determinants of Healthcare Access for Rural Elderly Women - A Systematic Review of Quantitative Studies. ACTA ACUST UNITED AC 2017. [DOI: 10.2174/1874944501710010244] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:This review aimed to explore and analyze the social determinants that impact rural women’s aged 60 years and older healthcare access in low or middle income and high income countries.Methods:Major healthcare databases including MEDLINE and MEDLINE In-Process, PsycINFO, PubMed, ProQuest, Web of Science, CINAHL and ERIC were searched from April 2016 to August 2016 and a manual search was also conducted. A rigorous selection process focusing on the inclusion of rural elderly women in study population and the social determinants of their healthcare access resulted in 38 quantitative articles for inclusion. Data were extracted and summarized from these studies, and grouped into seven categories under upstream and downstream social determinants.Results:Prevailing healthcare systems in combination with personal beliefs and ideas about ageing and healthcare were identified as significant determinants. Socioeconomic and cultural determinants also had a statistically significant negative impact on the access to healthcare services, especially in developing countries.Conclusion:Potentially, improvements to healthcare access can be achieved through consideration of rural elderly women’s overall status including healthcare needs, socioeconomic determinants and cultural issues rather than simply establishing healthcare centers.
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Moosazadeh M, Amiresmaili M, Karimi S, Arabpoor M, Afshari M. APPRAISAL OF ACCESS TO DENTAL SERVICES IN SOUTH EAST OF IRAN USING FIVE AS MODEL. Mater Sociomed 2016; 28:196-200. [PMID: 27482161 PMCID: PMC4949035 DOI: 10.5455/msm.2016.28.196-200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Access to dental services not only refers to utilization but also to the extent by which the utilization is judged according to professional norms. This study aimed to study the access to dental services using the Five As model. METHODS This cross sectional study was conducted in southeast of Iran. A sample of 400 subjects participated in the study according to a multistage sampling method. A questionnaire was used for data collection. Data were analyzed using independent T test, ANOVA and multivariate linear regression models by means of SPSS V.20 software. FINDINGS Affordability, availability, accessibility, accommodation and acceptability mean scores were 58.2±12.2, 53.9±12.9, 59.4±15.7, 60.2±8.6, 70±11.5 and 60.3±7.4 respectively. According to multivariate linear regression models, there was significant associations between affordability and age, education level, having basic insurance and family income. Moreover, total accessibility was significantly correlated with education and monthly family income. CONCLUSION This study showed that access to dental services was at the moderate level among the studied population. It also revealed that age, basic insurance coverage, family income and level of education, are determinants of this accessibility.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Amiresmaili
- Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Karimi
- School of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahboobeh Arabpoor
- School of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
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Hong Y, Yao Q, Yang Y, Feng JJ, Wu SD, Ji WX, Yao L, Liu ZY. Knowledge structure and theme trends analysis on general practitioner research: A Co-word perspective. BMC FAMILY PRACTICE 2016; 17:10. [PMID: 26831329 PMCID: PMC4734860 DOI: 10.1186/s12875-016-0403-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 01/15/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND General practitioners (GPs) are the most important providers of primary health care, as proven by related research published several decades ago. However, the knowledge structure and theme trends of such research remain unclear. Accordingly, this study aimed to provide an overview of the development of research on GPs over the period of 1999 to 2014. METHODS Studies on GPs conducted from 1999 to 2014 were retrieved from PubMed. In this work, co-word, social network analysis, and theme trends analyses were conducted to reveal the knowledge structures and thematic evolution of research on GPs. RESULTS The number of conducted studies on GPs increased. However, growth speed slowed down during the past 16 years. A total of 27 high-frequency keywords were identified in 1999 to 2003, and more new and specific high-frequency keywords emerged in the subsequent periods. The dynamic of this field was first divergent and then considered convergent. Specifically, network centralization is 19.77%, 19.09%, and 13.04% in 1999 to 2003, 2004 to 2008 and 2009 to 2014, respectively. The major topics of research on GPs completed from 1999 to 2014 were "physician/family,""attitude of health personnel," and "primary health care," and "general practitioner" communities, and so on. CONCLUSION The research themes on GPs are relatively stable at the beginning of the 21(st) century. However, the thematic evolution and research topics of research on GPs are changing dynamically in recent years. Themes related to the roles and competencies of GPs, and the relations between general practitioner and patients/others have become research foci on GPs. In addition, more substantial research especially on comprehensive approaches and holistic modeling, which have been defined in the European Definition of General Practice/Family Medicine, are expected to be accomplished.
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Affiliation(s)
- Yang Hong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, 430072, Hubei, China.
| | - Ying Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jun-Jian Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shu-de Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wen-Xue Ji
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Lan Yao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhi-Yong Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Byles JE, Francis JL, Chojenta CL, Hubbard IJ. Long-term survival of older Australian women with a history of stroke. J Stroke Cerebrovasc Dis 2014; 24:53-60. [PMID: 25440353 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/06/2014] [Accepted: 07/27/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although many people survive an initial stroke, little is known about long-term impacts of stroke on survival. METHODS Data from the Australian Longitudinal Study on Women's Health were used to compare 12-year survival rates in older women with prevalent stroke, incident stroke, and no stroke. Cox regression models were fitted to assess the effect of lifestyle and demographic characteristics on the relationship between stroke and all-cause mortality. The "no stroke" group was used as the reference category in all statistical models. RESULTS At baseline, 4% of the women reported a previous stroke (prevalent stroke). At survey 2 in 1999, a further 3% reported having a stroke between 1996 and 1999 (incident stroke). Stroke was significantly associated with reduced long-term survival. Age-adjusted hazards ratios (HRs) were: 1.64 (1.43-1.89) for the "prevalent stroke" group and 2.29 (1.97-2.66) for the "incident stroke" group. Adjusting for comorbidities reduced the HRs, but the risk of death was still significantly higher in the 2 stroke groups. Adjusting for demographic and lifestyle factors did not make any further difference to the relationship between stroke and survival. However, obesity and past smoking were also risk factors for mortality. CONCLUSIONS This study highlights the long-term impacts of stroke on life expectancy and the importance of comorbidities and other lifestyle factors in affecting poststroke survival.
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Affiliation(s)
- Julie E Byles
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
| | - Jerryl Lynn Francis
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine L Chojenta
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Isobel J Hubbard
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
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An exploration of rural–urban differences in healthcare-seeking trajectories: Implications for measures of accessibility. Health Place 2014; 28:92-8. [DOI: 10.1016/j.healthplace.2014.03.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 03/13/2014] [Accepted: 03/21/2014] [Indexed: 11/18/2022]
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Schmied V, Johnson M, Naidoo N, Austin MP, Matthey S, Kemp L, Mills A, Meade T, Yeo A. Maternal mental health in Australia and New Zealand: A review of longitudinal studies. Women Birth 2013; 26:167-78. [DOI: 10.1016/j.wombi.2013.02.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 01/03/2013] [Accepted: 02/12/2013] [Indexed: 10/26/2022]
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Dewulf B, Neutens T, De Weerdt Y, Van de Weghe N. Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas. BMC FAMILY PRACTICE 2013; 14:122. [PMID: 23964751 PMCID: PMC3765409 DOI: 10.1186/1471-2296-14-122] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/20/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. METHODS Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. RESULTS The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. CONCLUSIONS The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g., census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research methodological differences and modifiable areal unit problems have remained largely overlooked, this manuscript shows that these aspects have a significant influence on the insights obtained. Hence, it is important for policy makers to ascertain to what extent their policy evaluations hold under different scales of analysis and when different methods are used.
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Affiliation(s)
- Bart Dewulf
- Department of Geography, Ghent University, Krijgslaan 281, S8, B-9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, B-1000 Brussels, Belgium
- VITO, Boeretang 200, Mol B-2400, Belgium
| | - Tijs Neutens
- Department of Geography, Ghent University, Krijgslaan 281, S8, B-9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, B-1000 Brussels, Belgium
| | | | - Nico Van de Weghe
- Department of Geography, Ghent University, Krijgslaan 281, S8, B-9000 Ghent, Belgium
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DiGiacomo M, Davidson PM, Byles J, Nolan MT. An integrative and socio-cultural perspective of health, wealth, and adjustment in widowhood. Health Care Women Int 2013; 34:1067-83. [PMID: 23477629 DOI: 10.1080/07399332.2012.712171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Women comprise a larger proportion of the ageing population than men, often outlive their spouses, and face a variety of challenges upon widowhood. Discrete aspects of the health impact of widowhood have been described in the literature; however, the expanse of sociocontextual issues that impact on older women's adjustment is less prominent. We undertook a literature review to synthesize recent research and interventions and identify current trends and gaps in knowledge and services. Although many health, social, cultural, and economic factors impact on recently widowed older women throughout the world, we found that few interventions targeting this population incorporate these factors.
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Affiliation(s)
- Michelle DiGiacomo
- a Centre for Cardiovascular and Chronic Care, Faculty of Health , University of Technology Sydney , Broadway , New South Wales , Australia
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Meurk C, Broom A, Adams J, Sibbritt D. Rurality, mobility, identity: women's use of complementary and alternative medicine in rural Australia. Health Place 2013; 20:75-80. [PMID: 23385030 DOI: 10.1016/j.healthplace.2012.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 12/17/2012] [Accepted: 12/22/2012] [Indexed: 10/27/2022]
Abstract
This article explores why women in rural and remote areas of Australia use complementary and alternative medicine (CAM) at higher rates than their counterparts in urban areas. Drawing on qualitative interviews with 60 women 60-65 years of age, currently living in rural Australia, we explore the possibility that CAM use in rural areas may be embedded in processes of spatialised identity-building and the health-creating practices of mobile, ex-urban, individuals who drive this process. We problematise previous explanations which suggest CAM use in rural areas is principally derived from a lack of biomedical service provision and enhanced community ties showing instead how and why identity and mobility are useful additional variables for understanding CAM use in rural areas.
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Affiliation(s)
- Carla Meurk
- University of Queensland, St Lucia Qld 4072, Australia.
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Byles JE, Dolja‐Gore X, Loxton DJ, Parkinson L, Stewart Williams JA. Women's uptake of Medicare Benefits Schedule mental health items for general practitioners, psychologists and other allied mental health professionals. Med J Aust 2011; 194:175-9. [DOI: 10.5694/j.1326-5377.2011.tb03765.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 11/02/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Julie E Byles
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW
| | - Xenia Dolja‐Gore
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW
| | - Deborah J Loxton
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW
| | - Lynne Parkinson
- Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW
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Zhang J, Oldenburg B, Turrell G. Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia. BMC Health Serv Res 2009; 9:218. [PMID: 19954549 PMCID: PMC2797786 DOI: 10.1186/1472-6963-9-218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 12/03/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia. METHODS Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent). RESULTS The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75. CONCLUSION The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.
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Affiliation(s)
- Jianzhen Zhang
- School of Medicine, University of Queensland, Herston Road, Herston, Brisbane QLD 4006, Australia
| | - Brian Oldenburg
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Gavin Turrell
- School of Public Health, Queensland University of Technology, Queensland, Australia
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Young AF, Dobson AJ, Byles JE. Health services research using linked records: who consents and what is the gain? Aust N Z J Public Health 2009. [DOI: 10.1111/j.1467-842x.2001.tb00284.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Khan A, Hussain R, Plummer D, Minichiello V. Method: Factors associated with bulk billing: experience from a general practitioners' survey in New South Wales. Aust N Z J Public Health 2008; 28:135-9. [PMID: 15233352 DOI: 10.1111/j.1467-842x.2004.tb00926.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To assess whether some demographic and practice characteristics of general practitioners (GPs) are associated with the use of bulk billing. METHODS A cross-sectional postal survey was conducted in late 2002 with a 15% stratified random sample, based on sex and area of practice, of currently practising GPs in New South Wales. Multinomial logistic regression was used to look at GPs' characteristics associated with their self-reported use of bulk billing. RESULTS Of the 494 GPs who participated in the study, 44% bulk billed for all patient consultations, 34% for selective patients, while 22% did not bulk bill for any patient. Multivariate analysis revealed that GPs practising in metropolitan areas were six times more likely to bulk bill for all patients compared with GPs in rural areas (OR 6.7, 95% CI 3.8-11.9). Overseas-trained GPs were twice as likely to bulk bill for all patients compared with locally trained GPs (OR 2.3, 95% CI 1.2-4.3). The likelihood of bulk billing for all patients also increased with an increase in GPs' caseload. CONCLUSIONS This paper discusses some of the policy and programmatic implications of the changing pattern of bulk billing. Special efforts are needed to provide increased practice support for GPs in rural and remote areas in order to ensure affordable and accessible GP services.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health, University of New England, Armidale, New South Wales.
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Turrell G, Oldenburg BF, Harris E, Jolley D. Social Inequality: Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness. Aust N Z J Public Health 2008; 28:152-8. [PMID: 15233355 DOI: 10.1111/j.1467-842x.2004.tb00929.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the association between socio-economic status (SES) and GP utilisation across Statistical Local Areas (SLAs) that differed in their geographic remoteness, and to assess whether Indigenous status and GP availability modified the association. DESIGN Retrospective analysis of Medicare data for all unreferred GP consultations (1996/97) for 952 SLAs comprising the six Australian States. Geographic remoteness was ascertained using the Area Remoteness Index of Australia (ARIA), and SES was measured by grouping SLAs into tertiles based on their Index of Relative Socioeconomic Disadvantage score. MAIN OUTCOME MEASURE Age/sex standardised rates of GP utilisation for each SLA. MAIN RESULTS In SLAs classified as 'highly accessible', rates of GP use were 10.8% higher (95% CI 5.7-16.0) in the most socio-economically disadvantaged tertile after adjustment for Indigenous status and GP availability. A very different pattern of GP utilsation was found in 'remote/very remote' SLAs. After adjustment, rates of GP use in the most socio-economically disadvantaged tertile were 25.3% lower (95% CI 5.9-40.7) than in the most advantaged tertile. CONCLUSIONS People in socio-economically disadvantaged metropolitan SLAs have higher rates of GP utilisation, as would be expected due to their poorer health. This is not true for people living in disadvantaged remote/very remote SLAs: in these areas, those most in need of GP services are least likely to receive them. Australia may lay claim to having a primary health care system that provides universal coverage, but we are still some way from having a system that is economically and geographically accessible to all.
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Affiliation(s)
- Gavin Turrell
- School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland.
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16
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HALCOMB ELIZABETHJ, DAVIDSON PATRICIAM, PATTERSON ELIZABETH. Promoting leadership and management in Australian general practice nursing: what will it take? J Nurs Manag 2008; 16:846-52. [DOI: 10.1111/j.1365-2834.2008.00938.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Byles JE, Young AF, Wheway VL. Annual health assessments for older Australian women: uptake and equity. Aust N Z J Public Health 2007; 31:170-3. [PMID: 17461009 DOI: 10.1111/j.1753-6405.2007.00036.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To measure utilisation of Enhanced Primary Care (EPC) health assessment items for women aged 75 years and over, and to describe health and socio-demographic characteristics of users and non-users. METHOD Analysis of longitudinal survey and Medicare claims data from women in the Australian Longitudinal Study on Women's Health (ALSWH) aged 75 to 78 years when EPC items were introduced and who provided permission to access their Medicare records for the period 1999-2003 (n = 4,646). RESULTS There was an increase in uptake of assessments over four years: from November 1999, 12% of eligible women had a health assessment during the following year; by October 2003, 49% had at least one health assessment ever. Few had repeat assessments. Women who visited a GP more often and who were satisfied with the number of GPs available were more likely to have an assessment in the first 12 months, and women who visited a GP more often, those taking more medications, and those caring for another were more likely to have at least one assessment in four years. Women in smaller rural and remote areas were less likely to have an assessment than women in urban areas. CONCLUSIONS Most women are not having annual assessments and there is some geographic inequity.
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Affiliation(s)
- Julie E Byles
- Research Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, Callaghan, New South Wales.
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18
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Sibbritt DW, Adams J, Young AF. A longitudinal analysis of mid-age women's use of complementary and alternative medicine (CAM) in Australia, 1996-1998. Women Health 2005; 40:41-56. [PMID: 15911509 DOI: 10.1300/j013v40n04_03] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Complementary and Alternative Medicine (CAM) has become increasingly popular amongst healthcare consumers world-wide. As such, CAM is now an important public health issue with taking non-prescription medications. This paper constitutes an exploratory investigation into CAM use over time. As such, there is need for further research to provide in-depth examination of the adoption and relinquishment of CAM use over a longer time period. serious implications for healthcare organization and delivery. While previous studies have provided a profile of CAM users, there remains very limited analysis of CAM consumption over time. The purpose of this paper is to describe the changing use of CAM practitioners over time by 11,454 mid-age women in the Australian Longitudinal Study on Women's Health. Over the study period (1996-1998), 10% of women adopted the use of CAM and 9% relinquished CAM. The predominant factor found to be predictive of CAM adoption was changes in health status. Specifically, those women experiencing more illness over time are more likely to adopt CAM than those experiencing no change or better health. CAM relinquishment was associated with use of non-prescription medications, where women were more likely to relinquish CAM if they never used non-prescription medications or if they stopped.
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Affiliation(s)
- David W Sibbritt
- Centre for Clinical Epidemiology and Biostatistics, Level 3, David Maddison Bldg, Watt St, Newcastle, Australia.
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Young AF, Dobson AJ. The decline in bulk‐billing and increase in out‐of‐pocket costs for general practice consultations in rural areas of Australia, 1995–2001. Med J Aust 2003. [DOI: 10.5694/j.1326-5377.2003.tb05102.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Anne F Young
- Research Centre for Gender and Health, University of Newcastle, Callaghan, NSW
| | - Annette J Dobson
- School of Population Health, University of Queensland, Herston, QLD
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Young AF, Dobson AJ, Byles JE. Health services research using linked records: who consents and what is the gain? Aust N Z J Public Health 2001. [DOI: 10.1111/j.1467-842x.2001.tb00649.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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