[Differences between rural and urban general practice activities].
OBJECTIVE
It is an established opinion that doctors working in rural setting are the "real general practitioners" doctors who have a broader working and responsibility range when compared to their colleagues who work in urban setting.


OBJECTIVE
The aim of the study was to explore whether there were differences in health care service between an urban and a rural GP office by comparing the number of visits, physical examinations, house calls and treatment costs, and to determine the impact of different age groups (regardless of the number of patients under GP care) on the frequency and type of visits to GP office, drug utilization and prescription.


METHODS
The study was conducted at an urban GP office (Pozega) and a rural GP office (Velika) with a catchment population of 2063 and 2031 individuals, respectively (both offices employ family medicine specialists). Data were collected from monthly reports containing information on age groups, total number of visits, physical examinations, house calls, prescriptions and referrals during 2003. In addition, financial costs associated with prescribed drugs were compared between the two offices. On data analysis, descriptive distribution and distribution analysis were used. Differences between data were estimated by use of chi2-test.


RESULTS
In the urban and rural GP offices 97.3% and only 69.6% of the population was older than 18, respectively. In urban GP office there was a mean of 7.35 visits per user per year, whereas in rural GP office the respective figure was 6.43, yielding a statistically significant difference (chi2 = 15.86; df = 1; p < 0.001). In urban GP office there were more house calls, the difference being statistically significant (chi2 = 51.91; df = 1; p < 0.001). Urban GP office also recorded a statistically significantly higher rate of referrals than rural office (chi = 31.22; df = 1; p < 0.001). The urban and rural GP offices differed in the mean number of prescriptions per patient (8.96 vs. 5.81), mean prescription cost (63.60 vs. 55.54 HRK); mean prescription cost per person (570.19 vs. 323.05 HRK), and index of financial expenditure of the predetermined amount assigned to drugs (135.7% vs. 92.32%).


CONCLUSIONS
Results of this study showed the different age group structure (regardless of the catchment population size) to determine the number of visits to GP office, total prescription cost and number of referrals. It is therefore of utmost importance to acknowledge the importance of patient age group structure as it has great influence in determining the type of care a GP has to offer and the cost associated with it.
Simunović
Rajka
R
branko.simunovic1@po.t-com.hr
Katić
Milica
M
Todorović
Goran
G
Vinter-Repalust
Nevenka
N
Petric
Dragomir
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D017523:Croatia; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D019035:Rural Health Services / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000706:statistics & numerical data*