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The influence of geographical location on the complexity of rural general practice activities

Med J Aust 2003; 179 (8): 416-420.

Summary

Objectives: To examine the complexity of activities undertaken in general practice in relation to degree of rurality of the practice.

Design and setting: National mail questionnaire survey across non-metropolitan Australia in July 2002.

Participants: 1498 respondents out of 4406 GPs providing at least 375  Medicare-rebatable consultations in rural and remote locations during January–March 2002 (response rate, 35%).

Main outcome measures: Responses to five sentinel measures of practice complexity.

Results: In general, the proportion of GPs providing complex services increases with increasing rurality or remoteness. Isolated rural and remote GPs manage myocardial infarctions to a higher level than GPs in larger rural and regional centres, are more likely to administer cytotoxic drugs, perform forensic examinations, stabilise injured patients pending retrieval, and coordinate discharge planning more often.

Conclusions: The more rural or remote the area, the more likely a GP is to be regularly engaged in complex care. These findings have implications for the workload, responsibility, vocational satisfaction, need for professional education and support, and costs and remuneration of practice.

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  • John S Humphreys1
  • Judith A Jones2
  • Michael P Jones3
  • David Mildenhall4
  • Paul R Mara5
  • Bruce Chater6
  • David R Rosenthal7
  • Nola M Maxfield8
  • Michael A Adena9

  • 1 School of Rural Health, Monash University, North Bendigo, VIC.
  • 2 Jones & Just, Mt Kuringai, NSW.
  • 3 University of Western Australia, Albany, WA.
  • 4 Health Connections, Gundagai, NSW.
  • 5 Theodore, QLD.
  • 6 Parallel Rural Community Curriculum, Renmark, SA.
  • 7 Wonthaggi Medical Group, Wonthaggi, VIC.
  • 8 Covance Pty Ltd, Ainslie, ACT.

Correspondence: 

Acknowledgements: 

This research was funded through the Commonwealth Department of Health and Ageing General Practice Branch, under the auspices of the Rural Doctors Association of Australia in association with Monash University School of Rural Health, Bendigo. Particular thanks go to Gordon Calcino, Naarilla Hirsch, Angela Mikalauskas and Caroline Fredericks for their assistance in expediting access to HIC data; to Fiona Blackshaw and Sybille McKeown from the Statistical Clearing House, Anna Boots from the Rural Doctors Association of Australia, and Vanessa Prince and Marg Bibic from Monash University.

Competing interests:

None identified.

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