title: Barriers to effective primary health care for adolescents.
abstract: OBJECTIVE
  To assess general practitioners' (GPs') perceptions of barriers in the health care system that hinder provision of effective adolescent health care; and to assess the training needs of GPs for a future education program in adolescent health issues.
  
  
  METHODS
  Retrospective questionnaire survey.
  
  
  METHODS
  A 66-item questionnaire was mailed during May and June 1995 to a random stratified sample of 997 rural and urban Victorian GPs. A Practice Assessment Task enabling respondents to fulfil Royal Australian College of General Practitioners' quality assurance requirements was mailed on return of completed questionnaires if requested.
  
  
  RESULTS
  The response rate was 72.4%. After adjusting for stratified sampling, 77% (95% confidence interval [CI], 73%-81%) of respondents favoured individual Medicare cards for adolescents from the age of 16. Thirty-eight per cent (95% CI, 34%-43%) were less willing to charge for longer consultations because they feared Health Insurance Commission (HIC) investigation. Most respondents indicated that their undergraduate training in adolescent mental health issues was inadequate and 64% (95% CI, 61%-68%) found it difficult to obtain advice about complex mental health problems. An interest in continuing medical education in adolescent health issues was expressed by 82% (95% CI, 79%-86%) of respondents.
  
  
  CONCLUSIONS
  Individual Medicare cards should be automatically issued to adolescents from the age of 16 to improve their ability to access health care. Revision of the Medicare rebate system and clarification of HIC's investigative functions may improve GP's effectiveness in adolescent consultations. Undergraduate medical and GP training should include curriculum relevant to adolescent health care.
authors.affiliation: Centre for Adolescent Health, Royal Children's Hospital, University of Melbourne, VIC. veitf@cryptic.rch.unimelb.edu.au
authors.forename: F C
authors.initials: FC
authors.lastname: Veit
authors.forename: L A
authors.initials: LA
authors.lastname: Sanci
authors.forename: C M
authors.initials: CM
authors.lastname: Coffey
authors.forename: D Y
authors.initials: DY
authors.lastname: Young
authors.forename: G
authors.initials: G
authors.lastname: Bowes
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000295:Adolescent Medicine / Q000193:education*; D001291:Attitude of Health Personnel; D001315:Australia; D003625:Data Collection; D005194:Family Practice / Q000193:education; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D008297:Male; D012189:Retrospective Studies