The University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; and GP Synergy, NSW & ACT Research and Evaluation Unit, Level 1, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.
The University of Queensland, Faculty of Medicine, Primary Care Clinical Unit, 288 Herston Road, Herston, Qld 4006, Australia.
Aust J Prim Health. 2022 Apr;28(2):104-109. doi: 10.1071/PY21179.
Socioeconomic disadvantage and the 'inverse care law' have significant effects on the health and well-being of Australians. Early career GPs can help address the needs of socioeconomically disadvantaged communities by choosing to practice in these locations. This study addressed an evidence gap around GPs post-Fellowship (within 2 years) practice location, and whether practice location is related to postgraduate vocational training.
This was a cross-sectional questionnaire-based study of recently Fellowed GPs from New South Wales, the Australian Capital Territory, Victoria and Tasmania. Questionnaire items elicited information about participants' current practice, including location. Where consent was provided, participants' questionnaire responses were linked to previously collected vocational GP training data. The outcome factor in analyses was practice location socioeconomic status (SES): the four deciles of greater socioeconomic disadvantage versus locations with a higher SES. SES was classified according to the Socio-Economic Indexes for Areas - Index of Relative Socioeconomic Disadvantage. Multivariable logistic regression was undertaken.
Of participants currently working in clinical general practice, 26% were practicing in the four deciles of greater socioeconomic disadvantage. Significant multivariable associations of working in these locations included having trained in a practice located in an area of greater socioeconomic disadvantage (odds ratio (OR) 3.14), and having worked at their current practice during vocational training (OR 2.99).
Given the association of training and practice location for recently Fellowed GPs, policies focused on training location may help in addressing ongoing workforce issues faced by areas of higher socioeconomic disadvantage.
社会经济劣势和“反向护理定律”对澳大利亚人的健康和福祉有重大影响。初级保健医生通过选择在这些地方行医，可以帮助解决社会经济弱势群体的需求。本研究旨在填补全科医生毕业后（2 年内）实践地点方面的证据空白，并探讨实践地点是否与研究生职业培训有关。
这是一项针对新南威尔士州、澳大利亚首都领地、维多利亚州和塔斯马尼亚州最近获得研究员资格的全科医生的横断面问卷调查研究。问卷项目收集了参与者当前实践的信息，包括地点。在获得同意的情况下，将参与者的问卷答复与之前收集的职业 GP 培训数据相关联。分析中的结果因素是实践地点的社会经济地位（SES）：四个较不利的 SES 阶层与 SES 较高的地点。SES 根据社会经济区域指数-相对社会经济劣势指数进行分类。进行了多变量逻辑回归分析。
在目前从事临床全科医疗工作的参与者中，有 26%的人在社会经济劣势较大的四个阶层中执业。在这些地方工作的显著多变量关联因素包括在社会经济劣势较大的地区接受培训的实践（优势比（OR）3.14），以及在职业培训期间在当前实践中工作（OR 2.99）。
鉴于最近获得研究员资格的医生培训和实践地点之间的关联，针对培训地点的政策可能有助于解决社会经济地位较高地区面临的持续劳动力问题。
