title: General practitioners and consultation drift: the effects of supply-side changes and reforms on service delivery patterns.
abstract: OBJECTIVE
  To determine what types of supply-side change underpinned the recent decline in longer (Level C and D) consultation provision and to evaluate the impact of the May 2010 reforms in realigning Medicare with long-term health policy objectives.
  
  
  METHODS
  Retrospective analysis of Level C and D consultation provision by general practitioners (GPs) across Australia. Outcome measures were extent (number of consultations per providing GP) and participation (proportion of GPs providing these consultations).
  
  
  RESULTS
  The proportion of GPs participating in Level C consultation provision is substantial (96%) and constant; however, extent of provision per GP decreased by 21% between 2006 and 2010. Level D participation decreased from 72% during 2006 to a nadir of 62% in 2009, and extent of provision decreased by 26% between 2006 and 2010.
  
  
  CONCLUSIONS
  Two distinct types of change underpinned the overall decline in Level C and D consultation provision. GPs appear to be providing Level C consultations less often, but the overwhelming majority still provide these consultations to some extent. The extent of provision of Level D consultations and the proportion of GPs providing them has decreased; an appreciable number of GPs simply stopped providing Level D consultations. Medicare reforms appear ineffective in realigning Medicare with long-term policy objectives.
authors: School of Public Health & Human Biosciences, Faculty of Health Sciences, La Trobe University, Bundoora, Vic. 3086, Australia. Email:
authors: Michael J
authors: MJ
authors: Taylor
authors: Dell
authors: D
authors: Horey
authors: Charles
authors: C
authors: Livingstone
authors: Siew-Pang
authors: SP
authors: Chan
authors: Hal
authors: H
authors: Swerissen
mesh_terms: D001315:Australia; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies