Published Papers - Abstract 48

Young AF, Dobson AJ & Byles J. Access and equity in the provision of general practitioner services for women in Australia. Australian and New Zealand Journal of Public Health, 2000; 24(5): 474-480

Objective: To assess geographical equity in the availability, accessibility and out of pocket costs of general practitioner (GP) services for women in Australia. Method: Data on general practice consultations during 1995 and 1996 for women aged 18-23 years (n=5,260), 45-50 years (n=7,898) and 70-75 years (n=6,542) in the Australian Longitudinal Study on Women's Health were obtained from the Health Insurance Commission. A substudy of 4,577 participants provided data on access to health services.Results: Older women were more likely to have no out of pocket costs for their GP consultations but in all age groups, the proportion was lower in rural areas than in urban areas (older age: 60% rural areas, 76% capital cities; mid age: 24% rural areas, 40% capital cities; young age: 35% rural areas, 52% capital cities). Among mid aged women, the median out of pocket cost per consultation ranged from $2.11 in capital cities to $6.48 in remote areas. Women living in rural and remote areas gave lower ratings for the availability, accessibility and affordability of health services than women living in urban areas.Conclusions: This study has shown a striking gradient in financial and non-financial barriers to health care associated with area of residence. Implications: The geographical imbalance in the supply and distribution of GP services in Australia has long been recognised but inequities in the affordability of services must also be addressed. Longitudinal survey data and Health Insurance Commission data provide a means to evaluate policies designed to improve access to health services in rural and remote areas.