The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times.
OBJECTIVE
To compare the rate of provision of longer consultations per head of population across practice locations categorised by socioeconomic status.


METHODS
Retrospective analysis of Medicare data for all consultations for all general practitioners in Australia for the 1998-99 and 1999-2000 financial years, grouped by postcode of practice location. Postcodes were categorised by the Socio-Economic Indexes for Areas, Index of Relative Socio-Economic Disadvantage score.


METHODS
Number of consultations and number of brief, standard, long and prolonged consultations per capita in each postcode grouping.


RESULTS
The absolute number of long plus prolonged consultations showed no trend across postcode groups, but the rate ratio per person was significantly higher in more advantaged postcode areas. This represents an example of care provision in inverse relationship to need.


CONCLUSIONS
Despite higher rates of chronic disease and lower rates of preventive care uptake, patients in low socioeconomic status areas receive longer GP consultations at a lower rate than patients in more advantaged areas. Possible strategies to overcome this inverse care provision include increased numbers of GPs in disadvantaged communities, removal of financial disincentives to longer consultations, and strengthening health promotion and community health services in disadvantaged areas.
Furler
John S
JS
Harris
Elizabeth
E
Chondros
Patty
P
Powell Davies
P Gawaine
PG
Harris
Mark F
MF
Young
Doris Y L
DY
D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011787:Quality of Health Care; D012189:Retrospective Studies; D012959:Socioeconomic Factors