Determinants of general practitioner use among women in Australia

This study investigates the use of general practitioner services by women i n Australia. Although there is a universal health insurance system (Medicar e) in Australia, there are variations in access to services and out of pock et costs for services. Survey data from 2350 mid-age (45-50 years) and 2102 older (70-75 years) women participating in the Australian Longitudinal Stu dy on Women's Health were linked with Medicare data to provide a range of i ndividual and contextual variables hypothesised to explain general practiti oner use. Structural equation modelling showed that physical health was the most powerful explanatory factor of general practitioner use. However, aft er adjusting for self-reported health, out of pocket cost per consultation was inversely associated with use of services. The out of pocket cost was g enerally lower for women with low socioeconomic status but cost was also di rectly related to geographical remoteness. Women living in more remote area s had higher out of pocket costs and poorer access to services. Women who r eported better access to care were more likely to be satisfied with their m ost recent general practice consultation and less likely to be sceptical of the value of medical care. These results show the need for health policies that improve the equitable use of general practitioner services in Austral ia. (C) 2001 Elsevier Science Ltd. All rights reserved.