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预测西澳大利亚州小区域层面的全科医生利用率。

Predicting general practitioner utilisation at a small area level across Western Australia.

作者信息

Lyle Greg, Hendrie Delia

机构信息

School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia; and Corresponding author. Email:

School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia.

出版信息

Aust J Prim Health. 2019 Jan;25(6):570-576. doi: 10.1071/PY19084.

Abstract

Equitable delivery of GP services is a key goal in universal healthcare systems. In Australia, information to evaluate equitable delivery is limited, especially at finer geographic scales, leaving an information void that needs to be filled to inform, prioritise and target interventions. To fill this void, GP utilisation was estimated by combining responses on GP utilisation from a national survey differentiated by demographic and area-based socioeconomic and remoteness characteristics with similar characteristics represented geographically at a fine scale. These estimates were then compared to actual GP utilisation to evaluate their predictive reliability. Comparable estimates were found in the greater metropolitan area, with 76% of areas having estimated GP utilisation within ±10% of actual utilisation. Larger discrepancies were found as areas became remoter, with 84% of areas reporting estimated utilisation that was higher than actual utilisation. Comparing the geographic differences between estimated and actual utilisation allowed us to examine the reliability of our methodology. Given the identified limitations, a proxy for GP utilisation at a small area level can be created, a dataset that is not currently published at this geography. This approach has the potential to be applied Australia-wide, providing another valuable tool to evaluate the equitable delivery of primary health care nationally.

摘要

全科医生服务的公平提供是全民医疗体系的一个关键目标。在澳大利亚,用于评估公平提供情况的信息有限,尤其是在更精细的地理尺度上,这留下了一个信息空白,需要加以填补,以便为干预措施提供信息、确定优先次序并确定目标。为了填补这一空白,通过将全国性调查中按人口、基于地区的社会经济和偏远程度特征区分的全科医生利用情况的答复与在精细尺度上以地理方式呈现的类似特征相结合,对全科医生利用情况进行了估计。然后将这些估计值与实际的全科医生利用情况进行比较,以评估其预测可靠性。在较大的都市区发现了可比的估计值,76%的地区估计的全科医生利用情况在实际利用情况的±10%以内。随着地区变得更加偏远,差异更大,84%的地区报告的估计利用情况高于实际利用情况。比较估计利用情况和实际利用情况之间的地理差异使我们能够检验我们方法的可靠性。鉴于已确定的局限性,可以创建一个小区域层面的全科医生利用情况代理指标,这是一个目前尚未在该地理层面公布的数据集。这种方法有可能在澳大利亚全国范围内应用,为评估全国初级卫生保健的公平提供提供另一个有价值的工具。

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