title: General practice and residential aged care: A qualitative study of barriers to access to care and the role of remuneration.
abstract: BACKGROUND
  More than 169,000 people live in residential aged care facilities (RACFs). As people age they use health services, particularly general practitioner (GP) services, more frequently but many GPs do not attend patients in RACFs.
  
  
  OBJECTIVE
  To examine GPs' perceptions of barriers to providing care to patients in RACFs.
  
  
  METHODS
  This study was conducted in June 2014 in the Bayside Medicare Local (BML) region in Victoria, Australia; all participants were drawn from this region. Two focus groups (FGs) were conducted. One was for GPs (n=5) that have a specific interest in practicing in RACFs, the other with RACF staff (n=8) representing public, private, and not-for-profit aged care providers. Results were presented to the Royal Australian College of General Practitioners (RACGP) National Standing Committee for General Practice Advocacy and Support for feedback and validation of the findings against national perspectives of the effect of remuneration on the provision of GP services in RACFs.
  
  
  RESULTS
  Remuneration problems are a barrier to the provision of GP services to patients in RACFs. These problems can be grouped into: direct remuneration, opportunity cost, additional administrative burden, and unremunerated work. GPs' perceptions of the effects of these problems on willingness to practice in RACFs are described.
  
  
  CONCLUSIONS
  Innovative models of remuneration for GPs attending RACFs are needed to ameliorate the problems identified. Such models need to capture and pay for activities that are time consuming but often unremunerated.
authors.affiliation: Benetas, Glenferrie South, VIC, Australia ; Monash University, Melbourne, VIC, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Burgess
authors.affiliation: Benetas, Glenferrie South, VIC, Australia ; Monash University, Melbourne, VIC, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Davis
authors.affiliation: Benetas, Glenferrie South, VIC, Australia ; Monash University, Melbourne, VIC, Australia.
authors.forename: Amee
authors.initials: A
authors.lastname: Morgans
keywords: General practice; access to care; remuneration; residential aged care