Graham Bree, Kruger Estie, Tennant Marc, Shiikha Yulia
School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia.
Aust J Prim Health. 2023 Oct;29(5):437-444. doi: 10.1071/PY22125.
The accessibility to affordable primary healthcare services contributes to population health and health equity. A key aspect to accessibility is the geographical distribution of primary healthcare services. Limited studies have assessed the nationwide spatial distribution of bulk billing-only medical practices or 'no-fee' services. The aim of this study was to provide a nationwide approximation of bulk billing-only services and evaluate the socio-demographic status and population characteristics in relation to the distribution of bulk billing-only GP services.
The methodology in this study used Geographic Information System (GIS) technology to map the locations of all bulk bulking-only medical practices collected in mid-2020 and linked this with population data. The population data and practice locations were analysed at the level of Statistical Areas Level 2 (SA2) regions and used the most recent Census data.
The study sample included (n =2095) bulk billing-only medical practice locations. The nationwide average Population-to-Practice (PtP) ratio was 1 practice to 8529 people for regions with access to bulk billing-only practice, and 57.4% of the Australian population lives within an SA2 that has access to at least one bulk billing-only medical practices. No significant associations were identified between practice distribution and area socio-economic status.
The study identified areas with low access to affordable GP services, with many SA2 regions having no access to bulk billing-only practices. Findings also indicate that there was no association between area socio-economic status and the distribution of bulk billing-only services.
获得负担得起的初级医疗服务有助于促进人群健康和健康公平。可及性的一个关键方面是初级医疗服务的地理分布。仅有少数研究评估了全国范围内仅提供批量计费医疗服务或“免费”服务的空间分布情况。本研究的目的是对全国范围内仅提供批量计费服务的情况进行大致估算，并评估与仅提供批量计费的全科医生服务分布相关的社会人口统计学状况和人群特征。
本研究采用地理信息系统（GIS）技术，绘制了2020年年中收集的所有仅提供批量计费医疗服务机构的位置，并将其与人口数据相关联。人口数据和医疗机构位置在统计区域2级（SA2）区域层面进行分析，并使用了最新的人口普查数据。
研究样本包括（n = 2095）个仅提供批量计费的医疗服务机构位置。对于可获得仅提供批量计费服务机构的地区，全国平均人口与机构比例为1个机构对应8529人，并且57.4%的澳大利亚人口居住在至少有一个仅提供批量计费医疗服务机构的SA2区域内。未发现机构分布与地区社会经济状况之间存在显著关联。
该研究确定了获得负担得起的全科医生服务机会较少的地区，许多SA2区域无法获得仅提供批量计费的服务。研究结果还表明，地区社会经济状况与仅提供批量计费服务的分布之间没有关联。
