Access and equity in the provision of general practitioner services for women in Australia.
OBJECTIVE
To assess geographical equity in the availability, accessibility and out-of-pocket costs of general practitioner (GP) services for women in Australia.


METHODS
Data on general practice consultations during 1995 and 1996 for women aged 18-23 years (n = 5,260), 45-50 years (n = 7,898) and 70-75 years (n = 6,542) in the Australian Longitudinal Study on Women's Health were obtained from the Health Insurance Commission. A sub-study of 4,577 participants provided data on access to health services.


RESULTS
Older women were more likely to have no out-of-pocket costs for their GP consultations, but in all age groups, the proportion was lower in rural areas than in urban areas (older age: 60% rural areas, 76% capital cities; mid-age: 24% rural areas, 40% capital cities; young age: 35% rural areas, 52% capital cities). Among mid-aged women, the median out-of-pocket cost per consultation ranged from $2.11 in capital cities to $6.48 in remote areas. Women living in rural and remote areas gave lower ratings for the availability, accessibility and affordability of health services than women living in urban areas.


CONCLUSIONS
This study has shown a striking gradient in financial and nonfinancial barriers to health care associated with area of residence.


CONCLUSIONS
The geographical imbalance in the supply and distribution of GP services in Australia has long been recognised but inequities in the affordability of services must also be addressed. Longitudinal survey data and Health Insurance Commission data provide a means to evaluate policies designed to improve access to health services in rural and remote areas.
Young
A F
AF
Research Centre for Gender and Health, University of Newcastle, New South Wales. stafy@cc.newcastle.edu.au
Dobson
A J
AJ
Byles
J E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005194:Family Practice / Q000191:economics / Q000458:organization & administration*; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009313:National Health Programs; D012935:Social Justice; D011795:Surveys and Questionnaires; D016387:Women's Health