Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage

The accessibility and spatial distribution of health services provided by t he main source of primary medical care in Australia - the general practice surgery - was investigated by level of social disadvantage of local catchme nt areas. All 459 general practice surgeries in Perth, an Australian city o f 1.2 million residents., were surveyed with a 94% response. Amount of serv ice provision was measured using weekly doctor-hours, available from consul ting rooms during opening hours, and associated nurse-hours of service. Acc ess factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, case of making a same day appointment, bulk -billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hour s of service provision were also greater (41.0h/1,000 most disadvantaged vs . 37.9h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas com pared with least disadvantaged areas (61 vs, 38%). However. populations liv ing in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%). to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs, 51%). While the overall picture of accessibility was favourable, there was consid erable variation in the type of services provided to different socioeconomi c groups. Health care planners should investigate the reasons for these dif ferences and advise Government to ensure that access factors affecting publ icly funded services are equitably distributed. (C) 2001 Elsevier Science L td. All rights reserved.