Measuring Relationships between Doctor Densities and Patient Visits: A Dog’s Breakfast of Small Area Health Geographies
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A number of small area geographies are used in Australia to investigate primary care relevant outcomes/behaviours and to manage the supply of Primary Care Providers (PCP) that influence these outcomes. However, very little research exists on the choice of a small area geography suitable for these purposes. We evaluated a large basket of Australian small area geographies to determine which geography is optimal for investigating relationships between PCP supply and the use of PCP services. We used linked data to evaluate the relationship between PCP supply and the likelihood of a patient visiting a PCP, after adjusting for individual level covariates. PCP supply was measured at different geographies including Local Government Areas (LGAs), Primary Health Networks (PHNs), Statistical Areas-1/2/3 and Remoteness Areas. Overall, the strongest relationships between PCP density and PCP use were found when LGAs were used to measure PCP density. Large geographies such as PHNs also detected strong relationships while custom built geographies such as Primary Care Service Areas were not significantly better than the rest. Existing geographies such as LGAs may be suitable for investigating the effect of PCP supply at state or national scales.
KeywordsPrimary care provider General practitioner Geographical information systems Shortage areas Local government areas Doctor density Small areas
This research was initiated at the Australian Primary Health Care Research Institute which was a key component of the Australia government funded Primary Health Care Research, Evaluation and Development (2000-2014) strategy. This research was completed using data collected through the 45 and Up Study (www.saxinstitute.org.au). The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW; and partners: the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; beyondblue; NSW Government Family & Community Services – Carers, Ageing and Disability Inclusion; and the Australian Red Cross Blood Service. We thank the many thousands of people participating in the 45 and Up Study. The linked Medicare Benefits Scheme and Pharmaceutical Benefits Scheme data were supplied to the 45 and Up Study by the Commonwealth Department of Human Services.
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