Social Inequality: Utilisation of general practitioner services by socio‐economic disadvantage and geographic remoteness

Autor: Gavin Turrell, Brian F. Oldenburg, Elizabeth Harris, Damien Jolley
Jazyk: angličtina
Rok vydání: 2004
Předmět:
Zdroj: Australian and New Zealand Journal of Public Health, Vol 28, Iss 2, Pp 152-158 (2004)
Druh dokumentu: article
ISSN: 1753-6405
1326-0200
1467-842X
DOI: 10.1111/j.1467-842X.2004.tb00929.x
Popis: 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.
Databáze: Directory of Open Access Journals
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