Volume 200 - Issue 2
Comprehensive primary health care and social determinants as top priorities
Author: Fran E Baum
Med J Aust 2014; 200 (2): 86-87. || doi: 10.5694/mja13.11308
Published online: 3 February 2014
Published online: 3 February 2014
In reply: Australian general practice generally provides good primary medical care. However, while Nelson says a significant amount of activity is disease prevention, the Bettering the Evaluation and Care of Health study indicates that, in terms of problems at general practitioner-patient encounters, prevention constitutes less than 9.1% of activity and, in terms of reasons for encounters, it constitutes less than 15.9%.1
The general practice model works ...
In reply: Australian general practice generally provides good primary medical care. However, while Nelson says a significant amount of activity is disease prevention, the Bettering the Evaluation and Care of Health study indicates that, in terms of problems at general practitioner–patient encounters, prevention constitutes less than 9.1% of activity and, in terms of reasons for encounters, it constitutes less than 15.9%.1
The general practice model works well for those whose lives enable them to schedule care and then attend regular appointments. Yet, for many, there are significant barriers to this care, including the low number of GPs in disadvantaged areas, and language and cultural barriers to effective use.
Our research has shown that primary health care services offer clinical services but, in addition, run groups, take particular measures to ensure their services are accessible2 (such as providing transport, making their services welcoming, and encouraging community participation in the planning and management) and engage in advocacy3 aimed at making their communities healthier, including some measures to address the social determinants.4 Australian general practice does not engage in this more comprehensive suite of health-prompting activities.
Competing interests
No relevant disclosures.
References
- Britt H, Miller G, Henderson J, et al. General practice activity in Australia 2011-12. Sydney: Sydney University Press, 2012. (General Practice Series no. 31.) http://ses.library.usyd.edu.au/handle/2123/8675 (accessed Nov 2013).
- Baum F, Freeman T, Lawless A, Jolley G. Community development – improving patient safety by enhancing the use of health services. Aust Fam Physician 2012; 41: 424-428. 0_i1142864
- Baum F, Freeman T, Jolley G, et al. Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory, Health Promot Int 2013; May 8 [Epub ahead of print]. doi: 10.1093/heapro/dat029. 0_i1142866
- Baum FE, Legge DG, Freeman T, et al. The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints. BMC Public Health 2013; 13: 460. 0_CBBGBFDG