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Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

General practitioner (family physician) workforce in Australia: comparing geographic data from surveys, a mailing list and medicare

Authors: Soumya Mazumdar, Paul Konings, Danielle Butler, Ian Stewart McRae

Published in: BMC Health Services Research | Issue 1/2013

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Abstract

Background

Good quality spatial data on Family Physicians or General Practitioners (GPs) are key to accurately measuring geographic access to primary health care. The validity of computed associations between health outcomes and measures of GP access such as GP density is contingent on geographical data quality. This is especially true in rural and remote areas, where GPs are often small in number and geographically dispersed. However, there has been limited effort in assessing the quality of nationally comprehensive, geographically explicit, GP datasets in Australia or elsewhere.
Our objective is to assess the extent of association or agreement between different spatially explicit nationwide GP workforce datasets in Australia. This is important since disagreement would imply differential relationships with primary healthcare relevant outcomes with different datasets. We also seek to enumerate these associations across categories of rurality or remoteness.

Method

We compute correlations of GP headcounts and workload contributions between four different datasets at two different geographical scales, across varying levels of rurality and remoteness.

Results

The datasets are in general agreement with each other at two different scales. Small numbers of absolute headcounts, with relatively larger fractions of locum GPs in rural areas cause unstable statistical estimates and divergences between datasets.

Conclusion

In the Australian context, many of the available geographic GP workforce datasets may be used for evaluating valid associations with health outcomes. However, caution must be exercised in interpreting associations between GP headcounts or workloads and outcomes in rural and remote areas. The methods used in these analyses may be replicated in other locales with multiple GP or physician datasets.
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Literature
1.
go back to reference Chang C-H, Stukel TA, Flood AB, Goodman DC: Primary care physician workforce and medicare beneficiaries’ health outcomes. JAMA. 2011, 305 (20): 2096-2104. 10.1001/jama.2011.665.CrossRefPubMedPubMedCentral Chang C-H, Stukel TA, Flood AB, Goodman DC: Primary care physician workforce and medicare beneficiaries’ health outcomes. JAMA. 2011, 305 (20): 2096-2104. 10.1001/jama.2011.665.CrossRefPubMedPubMedCentral
2.
go back to reference Guttmann A, Shipman SA, Lam K, Goodman DC, Stukel TA: Primary care physician supply and children’s health care use, access, and outcomes: findings from Canada. Pediatrics. 2010, 125 (6): 1119-1126. 10.1542/peds.2009-2821.CrossRefPubMed Guttmann A, Shipman SA, Lam K, Goodman DC, Stukel TA: Primary care physician supply and children’s health care use, access, and outcomes: findings from Canada. Pediatrics. 2010, 125 (6): 1119-1126. 10.1542/peds.2009-2821.CrossRefPubMed
3.
go back to reference Butler D, Petterson S, Bazemore AD, Kat A: Use of measures of socioeconomic deprivation in planning primary health care workforce and defining health care need in Australia. Aust J Rural Health. 2010, 10: 1440-1584. Butler D, Petterson S, Bazemore AD, Kat A: Use of measures of socioeconomic deprivation in planning primary health care workforce and defining health care need in Australia. Aust J Rural Health. 2010, 10: 1440-1584.
4.
go back to reference Wilkinson D: Inequitable distribution of general practitioners in Australia: analysis by state and territory using census data. Aust J Rural Health. 2000, 8 (2): 87-93. 10.1046/j.1440-1584.2000.00255.x.CrossRefPubMed Wilkinson D: Inequitable distribution of general practitioners in Australia: analysis by state and territory using census data. Aust J Rural Health. 2000, 8 (2): 87-93. 10.1046/j.1440-1584.2000.00255.x.CrossRefPubMed
5.
go back to reference Roeger LS, Reed RL, Smith BP: Equity of access in the spatial distribution of GPs within an Australian metropolitan city. Aust J Prim Health. 2010, 16 (4): 284-290. 10.1071/PY10021.CrossRefPubMed Roeger LS, Reed RL, Smith BP: Equity of access in the spatial distribution of GPs within an Australian metropolitan city. Aust J Prim Health. 2010, 16 (4): 284-290. 10.1071/PY10021.CrossRefPubMed
6.
go back to reference McGrail MR, Humphreys JS: Measuring spatial accessibility to primary care in rural areas: improving the effectiveness of the two-step floating catchment area method. Appl Geogr. 2009, 29 (4): 533-541. 10.1016/j.apgeog.2008.12.003.CrossRef McGrail MR, Humphreys JS: Measuring spatial accessibility to primary care in rural areas: improving the effectiveness of the two-step floating catchment area method. Appl Geogr. 2009, 29 (4): 533-541. 10.1016/j.apgeog.2008.12.003.CrossRef
9.
go back to reference McRae I: Doctors at work: determinants of supply and demand in the Australian GP market. 2008, Canberra: Australian National University McRae I: Doctors at work: determinants of supply and demand in the Australian GP market. 2008, Canberra: Australian National University
10.
go back to reference Wang F, Luo L, McLafferty S: Healthcare access, socioeconomic factors and late-stage cancer diagnosis: an exploratory spatial analysis and public policy implication. Int J Publ Pol. 2010, 5 (2): 237-258. Wang F, Luo L, McLafferty S: Healthcare access, socioeconomic factors and late-stage cancer diagnosis: an exploratory spatial analysis and public policy implication. Int J Publ Pol. 2010, 5 (2): 237-258.
11.
go back to reference McLafferty S, Wang F, Luo L, Butler J: Rural – urban inequalities in late-stage breast cancer: spatial and social dimensions of risk and access. Environ Plann Plann Des. 2011, 38 (4): 726-740. 10.1068/b36145.CrossRef McLafferty S, Wang F, Luo L, Butler J: Rural – urban inequalities in late-stage breast cancer: spatial and social dimensions of risk and access. Environ Plann Plann Des. 2011, 38 (4): 726-740. 10.1068/b36145.CrossRef
12.
go back to reference Butler DC, Petterson S, Phillips RL, Bazemore AW: Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery. Health Serv Res. 2012, 48 (2-Pt-1): 539-559.PubMedPubMedCentral Butler DC, Petterson S, Phillips RL, Bazemore AW: Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery. Health Serv Res. 2012, 48 (2-Pt-1): 539-559.PubMedPubMedCentral
13.
go back to reference Boukus E, Cassil A, O’Malley AS: vol. 35. A snapshot of U.S. physicians: Key findings from the 2008 health tracking physician survey. 2009, Washingdon, D.C: Center for Studying Health System Change (HSC) Boukus E, Cassil A, O’Malley AS: vol. 35. A snapshot of U.S. physicians: Key findings from the 2008 health tracking physician survey. 2009, Washingdon, D.C: Center for Studying Health System Change (HSC)
14.
go back to reference To T, Wajja A: Population demographic indicators associated with incidence of pyloric stenosis. Arch Pediatr Adolesc Med. 2005, 159 (6): 520-525. 10.1001/archpedi.159.6.520.CrossRefPubMed To T, Wajja A: Population demographic indicators associated with incidence of pyloric stenosis. Arch Pediatr Adolesc Med. 2005, 159 (6): 520-525. 10.1001/archpedi.159.6.520.CrossRefPubMed
15.
go back to reference Gorey KM, Luginaah IN, Holowaty EJ, Fung KY, Hamm C: Associations of physician supplies with breast cancer stage at diagnosis and survival in Ontario, 1988 to 2006. Cancer. 2009, 115 (15): 3563-3570. 10.1002/cncr.24401.CrossRefPubMedPubMedCentral Gorey KM, Luginaah IN, Holowaty EJ, Fung KY, Hamm C: Associations of physician supplies with breast cancer stage at diagnosis and survival in Ontario, 1988 to 2006. Cancer. 2009, 115 (15): 3563-3570. 10.1002/cncr.24401.CrossRefPubMedPubMedCentral
16.
go back to reference Roger PJ, Pong RW: Geographic distribution of physicians in Canada. 1999, Sudbury, ON: Centre for Rural and Northern Health Research: Laurentian University Roger PJ, Pong RW: Geographic distribution of physicians in Canada. 1999, Sudbury, ON: Centre for Rural and Northern Health Research: Laurentian University
17.
go back to reference Pong RW, Pitblado JR: Geographic distribution of physicians in Canada: beyond how many and where. 2005, Ottawa, ON: Canadian Institute for Health Information = Institut canadien d’information sur la santé Pong RW, Pitblado JR: Geographic distribution of physicians in Canada: beyond how many and where. 2005, Ottawa, ON: Canadian Institute for Health Information = Institut canadien d’information sur la santé
18.
go back to reference Sofianopoulou E, Rushton S, Rubin G, Pless-Mulloli T: Defining GP practice areas based on true service utilisation. Health Place. 2012, 18 (6): 1248-1254. 10.1016/j.healthplace.2012.08.006.CrossRefPubMed Sofianopoulou E, Rushton S, Rubin G, Pless-Mulloli T: Defining GP practice areas based on true service utilisation. Health Place. 2012, 18 (6): 1248-1254. 10.1016/j.healthplace.2012.08.006.CrossRefPubMed
19.
go back to reference Mowlam A, Lewis J: Exploring how General Practitioners work with patients on sick leave. 2005, Norwich, UK: Department for Work and Pensions Mowlam A, Lewis J: Exploring how General Practitioners work with patients on sick leave. 2005, Norwich, UK: Department for Work and Pensions
20.
go back to reference DoHA: Medicare Benefits Schedule Book: Operating from 01 January 2012. 2011, Canberra: Australian Government Department of Health and Ageing DoHA: Medicare Benefits Schedule Book: Operating from 01 January 2012. 2011, Canberra: Australian Government Department of Health and Ageing
21.
go back to reference Fairbrother J: Re: GP consultation statistics at small geographies - 2012/CO11549 [SEC = UNCLASSIFIED]. 2012, Canberra: Personal Communication Fairbrother J: Re: GP consultation statistics at small geographies - 2012/CO11549 [SEC = UNCLASSIFIED]. 2012, Canberra: Personal Communication
22.
go back to reference McRae I: vol. 6. Supply and demand for GP services in Australia. 2009, Canberra: Australian Center for Economic Research on Health McRae I: vol. 6. Supply and demand for GP services in Australia. 2009, Canberra: Australian Center for Economic Research on Health
23.
go back to reference NHPA: Healthy Communities: Australians’ experiences with primary health care in 2010–11. 2013, Canberra: National Health Performance Agency NHPA: Healthy Communities: Australians’ experiences with primary health care in 2010–11. 2013, Canberra: National Health Performance Agency
24.
go back to reference Joyce C, Wolfe R: Geographic distribution of the Australian primary health workforce in 1996 and 2001. Aust N Z J Public Health. 2005, 29: 129-135. 10.1111/j.1467-842X.2005.tb00062.x.CrossRefPubMed Joyce C, Wolfe R: Geographic distribution of the Australian primary health workforce in 1996 and 2001. Aust N Z J Public Health. 2005, 29: 129-135. 10.1111/j.1467-842X.2005.tb00062.x.CrossRefPubMed
25.
go back to reference Scott J, Larson A, Jefferies F, Veenendaal B: Small-area estimates of general practice workforce shortage in rural and remote Western Australia. Aust J Rural Health. 2006, 14 (5): 209-213. 10.1111/j.1440-1584.2006.00811.x.CrossRefPubMed Scott J, Larson A, Jefferies F, Veenendaal B: Small-area estimates of general practice workforce shortage in rural and remote Western Australia. Aust J Rural Health. 2006, 14 (5): 209-213. 10.1111/j.1440-1584.2006.00811.x.CrossRefPubMed
26.
go back to reference Steele L, Pacza T, Tennant M: Rural and remote oral health, problems and models for improvement: a Western Australian perspective. Aust J Rural Health. 2000, 8 (1): 22-28. 10.1046/j.1440-1584.2000.81224.x.CrossRefPubMed Steele L, Pacza T, Tennant M: Rural and remote oral health, problems and models for improvement: a Western Australian perspective. Aust J Rural Health. 2000, 8 (1): 22-28. 10.1046/j.1440-1584.2000.81224.x.CrossRefPubMed
27.
go back to reference Jones D: 2002 Australian radiology workforce report. Australas Radiol. 2002, 46 (3): 231-248. 10.1046/j.1440-1673.2002.01051.x.CrossRefPubMed Jones D: 2002 Australian radiology workforce report. Australas Radiol. 2002, 46 (3): 231-248. 10.1046/j.1440-1673.2002.01051.x.CrossRefPubMed
28.
go back to reference Pegram RW, Humphreys JS, Calcino G: Primary medical care workforce enumeration in rural and remote areas of Australia: time for a new approach?. Aust J Rural Health. 2006, 14 (1): 24-28. 10.1111/j.1440-1584.2006.00751.x.CrossRefPubMed Pegram RW, Humphreys JS, Calcino G: Primary medical care workforce enumeration in rural and remote areas of Australia: time for a new approach?. Aust J Rural Health. 2006, 14 (1): 24-28. 10.1111/j.1440-1584.2006.00751.x.CrossRefPubMed
29.
go back to reference Grinzi P, Bazemore A, Phillips RL: Navigating general practice. The use of geographic information systems. Aust Fam Physician. 2008, 37 (10): 855-858.PubMed Grinzi P, Bazemore A, Phillips RL: Navigating general practice. The use of geographic information systems. Aust Fam Physician. 2008, 37 (10): 855-858.PubMed
30.
go back to reference Saltman DC, Mant A: General practitioner databases in Australia. Med J Aust. 1992, 156: 16-20.PubMed Saltman DC, Mant A: General practitioner databases in Australia. Med J Aust. 1992, 156: 16-20.PubMed
31.
go back to reference Gill GF, Thomson AN, Pilotto LS: Identifying the active general practice workforce in one division of general practice:the utility of public domain database. Med J Aust. 1997, 166: 208-210.PubMed Gill GF, Thomson AN, Pilotto LS: Identifying the active general practice workforce in one division of general practice:the utility of public domain database. Med J Aust. 1997, 166: 208-210.PubMed
32.
go back to reference Cherkin D, Lawrence D: An evaluation of the American Medical Association’s Physician masterfile as a data source: One State’s experience. Med Care. 1977, 15 (9): 767-779. 10.1097/00005650-197709000-00004.CrossRefPubMed Cherkin D, Lawrence D: An evaluation of the American Medical Association’s Physician masterfile as a data source: One State’s experience. Med Care. 1977, 15 (9): 767-779. 10.1097/00005650-197709000-00004.CrossRefPubMed
33.
go back to reference Ananthakrishnan AN, Hoffmann RG, Saeian K: Higher physician density is associated with lower incidence of late-stage colorectal cancer. J Gen Intern Med. 2010, 25 (11): 1164-1171. 10.1007/s11606-010-1457-z.CrossRefPubMedPubMedCentral Ananthakrishnan AN, Hoffmann RG, Saeian K: Higher physician density is associated with lower incidence of late-stage colorectal cancer. J Gen Intern Med. 2010, 25 (11): 1164-1171. 10.1007/s11606-010-1457-z.CrossRefPubMedPubMedCentral
34.
go back to reference Roll K: The influence of regional health care structures on delay in diagnosis of rare diseases: the case of Marfan syndrome. Health Policy. 2012, 105 (2–3)): 119-127.CrossRefPubMed Roll K: The influence of regional health care structures on delay in diagnosis of rare diseases: the case of Marfan syndrome. Health Policy. 2012, 105 (2–3)): 119-127.CrossRefPubMed
35.
go back to reference NOVA: Review of the Queensland health rural generalist pathway (RGP) model to examine whether there is the potential to expand the model nationally. 2010, Melbourne: NOVA Public Policy P/L NOVA: Review of the Queensland health rural generalist pathway (RGP) model to examine whether there is the potential to expand the model nationally. 2010, Melbourne: NOVA Public Policy P/L
36.
go back to reference Sivey P, Scott A, Witt J, Joyce C, Humphreys J: Junior doctors’ preferences for specialty choice. J Health Econ. 2012, 31 (6): 813-823. 10.1016/j.jhealeco.2012.07.001.CrossRefPubMed Sivey P, Scott A, Witt J, Joyce C, Humphreys J: Junior doctors’ preferences for specialty choice. J Health Econ. 2012, 31 (6): 813-823. 10.1016/j.jhealeco.2012.07.001.CrossRefPubMed
37.
go back to reference AIHW: National health labour force series. vol. 44. Medical labour force 2007. National health labour force series. 2009, Canberra: AIHW AIHW: National health labour force series. vol. 44. Medical labour force 2007. National health labour force series. 2009, Canberra: AIHW
40.
go back to reference Dunne L: Measuring remoteness: accessibility/remoteness index of Australia (ARIA). 2001, Canberra: DoHA Dunne L: Measuring remoteness: accessibility/remoteness index of Australia (ARIA). 2001, Canberra: DoHA
42.
go back to reference ABS: ASGC Remoteness Classification: Purpose and Use (Census Paper No. 03/01). 2003, Canberra, ACT: Australian Bureau of Statistics ABS: ASGC Remoteness Classification: Purpose and Use (Census Paper No. 03/01). 2003, Canberra, ACT: Australian Bureau of Statistics
44.
go back to reference ESRI: ArcGIS 10.1. 2012, Redlands, California: Environmental Systems Research Institute ESRI: ArcGIS 10.1. 2012, Redlands, California: Environmental Systems Research Institute
45.
go back to reference Moran PAP: Notes on continuous stochastic phenomena. Biometrika. 1950, 37 (1/2): 17-23. 10.2307/2332142.CrossRefPubMed Moran PAP: Notes on continuous stochastic phenomena. Biometrika. 1950, 37 (1/2): 17-23. 10.2307/2332142.CrossRefPubMed
46.
go back to reference Wagstaff DA, Elek E: Using a nonparametric bootstrap to obtain a confidence interval for Pearson’s r with cluster randomized data: a case study. J Prim Prev. 2009, 30 (5): 497-512. 10.1007/s10935-009-0191-y.CrossRefPubMedPubMedCentral Wagstaff DA, Elek E: Using a nonparametric bootstrap to obtain a confidence interval for Pearson’s r with cluster randomized data: a case study. J Prim Prev. 2009, 30 (5): 497-512. 10.1007/s10935-009-0191-y.CrossRefPubMedPubMedCentral
47.
go back to reference Dove N: Can international medical graduates help solve Canada’s shortage of rural physicians?. Can J Rural Med. 2009, 14 (3): 120-123. Copyright Canadian Medical Association Summer 2009PubMed Dove N: Can international medical graduates help solve Canada’s shortage of rural physicians?. Can J Rural Med. 2009, 14 (3): 120-123. Copyright Canadian Medical Association Summer 2009PubMed
49.
go back to reference Mazumdar S, Rushton G, Smith BJ, Zimmerman DL, Donham KJ: Geocoding accuracy and the recovery of relationships between environmental exposures and health. Int J Health Geogr. 2008, 3: 7-13. Mazumdar S, Rushton G, Smith BJ, Zimmerman DL, Donham KJ: Geocoding accuracy and the recovery of relationships between environmental exposures and health. Int J Health Geogr. 2008, 3: 7-13.
51.
go back to reference Dubowitz T, Williams M, Steiner ED, Weden MM, Miyashiro L, Jacobson D, Lurie N: Using geographic information systems to match local health needs with public health services and programs. Am J Publ Health. 2011, 101 (9): 1664-1665.CrossRef Dubowitz T, Williams M, Steiner ED, Weden MM, Miyashiro L, Jacobson D, Lurie N: Using geographic information systems to match local health needs with public health services and programs. Am J Publ Health. 2011, 101 (9): 1664-1665.CrossRef
52.
go back to reference Ricketts TC, Randolph R: Urban–rural flows of physicians. J Rural Health. 2007, 23 (4): 277-285. 10.1111/j.1748-0361.2007.00104.x.CrossRefPubMed Ricketts TC, Randolph R: Urban–rural flows of physicians. J Rural Health. 2007, 23 (4): 277-285. 10.1111/j.1748-0361.2007.00104.x.CrossRefPubMed
53.
go back to reference Brewer N, Pearce N, Day P, Borman B: Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand. Aust N Z J Public Health. 2012, 36 (4): 335-342. 10.1111/j.1753-6405.2012.00843.x.CrossRef Brewer N, Pearce N, Day P, Borman B: Travel time and distance to health care only partially account for the ethnic inequalities in cervical cancer stage at diagnosis and mortality in New Zealand. Aust N Z J Public Health. 2012, 36 (4): 335-342. 10.1111/j.1753-6405.2012.00843.x.CrossRef
54.
go back to reference Hiscock R, Pearce J, Blakely T, Witten K: Is neighborhood access to health care provision associated with individual-level utilization and satisfaction?. Health Serv Res. 2008, 43 (6): 2183-2200. 10.1111/j.1475-6773.2008.00877.x.CrossRefPubMedPubMedCentral Hiscock R, Pearce J, Blakely T, Witten K: Is neighborhood access to health care provision associated with individual-level utilization and satisfaction?. Health Serv Res. 2008, 43 (6): 2183-2200. 10.1111/j.1475-6773.2008.00877.x.CrossRefPubMedPubMedCentral
55.
go back to reference NPHCP: Medicare Locals ‘fact sheet’ for National Primary Health Care Partnership members. 2011, Canberra: National Primary Health Care Partnership NPHCP: Medicare Locals ‘fact sheet’ for National Primary Health Care Partnership members. 2011, Canberra: National Primary Health Care Partnership
56.
go back to reference McLafferty S, Freeman VL, Barrett RE, Luo L, Shockley A: Spatial error in geocoding physician location data from the AMA Physician Masterfile: implications for spatial accessibility analysis. Spat Spatiotemporal Epidemiol. 2012, 3 (1): 31-38. 10.1016/j.sste.2012.02.004.CrossRefPubMed McLafferty S, Freeman VL, Barrett RE, Luo L, Shockley A: Spatial error in geocoding physician location data from the AMA Physician Masterfile: implications for spatial accessibility analysis. Spat Spatiotemporal Epidemiol. 2012, 3 (1): 31-38. 10.1016/j.sste.2012.02.004.CrossRefPubMed
57.
go back to reference Brunsdon C, Fotheringham AS, Charlton ME: Geographically weighted regression: a method for exploring spatial nonstationarity. Geogr Anal. 1996, 28 (4): 281-298.CrossRef Brunsdon C, Fotheringham AS, Charlton ME: Geographically weighted regression: a method for exploring spatial nonstationarity. Geogr Anal. 1996, 28 (4): 281-298.CrossRef
Metadata
Title
General practitioner (family physician) workforce in Australia: comparing geographic data from surveys, a mailing list and medicare
Authors
Soumya Mazumdar
Paul Konings
Danielle Butler
Ian Stewart McRae
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-343

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