News

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Use of general practice and enhanced primary care services rising

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The data, collated from a recent Australian Institute of Health and Welfare (AIHW) report, details the use of non-hospital Medicare-subsidised services, including general practice, allied health, and specialist and diagnostic imaging.
 
Between 2013 and 2018, more than 377 million Medicare-subsidised, non-hospital health services were used – 154 million (one in three) of which were in general practice.
 
GP visits equated to 21.6 million (88% of the population) in 2017–18, with 9.4 million people accessing diagnostic imaging (eg X-ray), nine million using a Medicare-subsidised allied health service (eg physiotherapy), and 7.6 million visiting a specialist.
 
The AIHW identifies that health services usage varies considerably depending on where a patient lives, reflecting differences in patients’ health and care preferences, population growth and accessibility of services, such as availability, costs and service options.
 
After-hours services
Access to general practice services was generally well distributed between regional and metro areas, with the exception of after-hours care.
 
Overall, the number of after-hours services available per person showed an increase of 8% from 2013–18.
 
The percentage of patients accessing GPs after-hours in 2017–18 was higher in metropolitan Primary Health Network (PHN) areas than in regional PHN areas (28% compared to 16%). The highest rate (37%) was in Western Sydney and the lowest (10%) in Western NSW.
 
Variations between PHNs
Out-of-pocket GP costs reoccurring across three PHN datasets in particular show a possible link between lower access and higher out-of-pocket costs.
 
Compared to the national average of $38.79, patients with the highest out-of-pocket costs per GP visit in 2017–18 were located in:

• NT – $46.58
• ACT – $44.06
• WA – $39.22

PHNs located in these states and territories had a lower percentage of patients visiting their GP during the same period:
 

• ACT PHN – 86.2%
• Country WA PHN – 83.2 %
• NT PHN – 77%

Compared across all PHNs, the three with the highest percentage of GP attendances were in South Western Sydney (94.1%), Nepean Blue Mountains (92.6%) and Western Sydney (91.2%).
 
The report draws no conclusions as to whether a higher or lower rate of service use is desirable for a particular area; however, some areas with lower rates of GP services usage appear to coincide with areas with higher out-of-pocket costs for GP services.
 
Some of the more remote PHNs saw a marked increase in the proportion of people using GP services during 2013–18. For example, 85% of the population in the Western Queensland PHN area saw a GP in 2017–18, compared with 75% in 2013–14.
 
Enhanced primary care services
Almost one in four Australians (23% of the population) used a GP-enhanced primary care service in 2017–18, and the proportion of the population receiving these services has risen steadily in every PHN area since 2013–14.
 
The largest increase was in the Western Queensland PHN, which increased from 14% in 2013–14 to 24% in 2017–18.
 
These enhanced primary care services include more comprehensive care items, such as chronic disease and mental health.
 
In 2017–18:
 

• 3.6 million people (15% of the population) had a chronic disease management plan prepared or reviewed
• 2.1 million people (8% of the population) had a GP Mental Health Treatment Plan created or reviewed
• one million people (4% of the population) had a health assessment for higher need groups.

Overall, a higher percentage (25%) of people living in regional PHN areas received enhanced primary care services than people living in metropolitan PHN areas (21%). The percentage of people who received these services ranged from 16% in ACT PHN areas to 34% in North Coast PHN areas.

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healthcare access Medicare patient costs PHNs

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