The impact of practice size and ownership on general practice care in Australia

Moel-Mandel, Caroline; Sundararajan, Vijaya

doi:10.5694/mja2.51038

Topics

Recent trends in general practice structure may have an impact on future patient care in Australia

The organisational structure of general practice in Australia has changed considerably since the late 1990s.1 Prompted by health care system changes, practice cost increases and incentives, originally small‐scaled general practices have merged into larger entities.1

La Trobe University, Melbourne, VIC

Correspondence: v.sundararajan@latrobe.edu.au

Competing interests:

No relevant disclosures.

1. Royal Australian College of General Practitioners. General Practice: Health of the Nation 2020. Melbourne: RACGP, 2019. https://www.racgp.org.au/getmedia/c2c12dae-21ed-445f-8e50-530305b0520a/Health-of-the-Nation-2020-WEB.pdf.aspx (viewed Oct 2020).
2. Royal Australian College of General Practitioners. General Practice: Health of the Nation 2019. Melbourne: RACGP, 2019. https://www.racgp.org.au/getmedia/bacc0983-cc7d-4810-b34a-25e12043a53e/Health-of-the-Nation-2019-report.pdf.aspx (viewed Oct 2020).
3. Joyce C, McDonald H, Lawlor-Smith L. General practitioners’ perceptions of different practice models: a qualitative study. Aust J Prim Health 2016; 22: 388–393.
4. Cowling TE, Laverty AA, Harris MJ, et al. Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey. J R Soc Med 2017; 110: 440–451.
5. Willis J, Antono B, Bazemore A, et al. The state of primary care in the United States: a chartbook of facts and statistics. Washington: Robert Graham Center, 2020. https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/PrimaryCareChartbook2021.pdf (viewed March 2021).
6. Holt E. Health in Sweden: a political issue. Lancet 2018; 392: 1184–1185.
7. Greatbanks R, Doolan-Noble F, McKenna A. Cheques and challenges: business performance in New Zealand general practice. J Prim Health Care 2017; 9: 185–190.
8. Commonwealth of Australia. Professional Services Review: annual report 2017–18. https://www.psr.gov.au/publications-and-resources/annual-reports (viewed Jan 2021).
9. Erny-Albrecht K, Bywood P. Corporatisation of general practice — impact and implications. Adelaide: Primary Health Care Research and Information Service, 2016. http://hdl.handle.net/2328/38389 (viewed Oct 2020).
10. Gravelle H, Scott A, Sivey P, et al. Competition, prices and quality in the market for physician consultations. J Ind Econ 2016; 64: 135–169.
11. McGowan H. Primary health care in the ACT: consumer experiences. Canberra: Health Care Consumers’ Association, 2014. https://www.aph.gov.au/DocumentStore.ashx?id=02344196-beb1-473f-be08-c556d379677c&subId=252668 (viewed March 2020).
12. Pereira Gray DJ, Sidaway-Lee K, White E, et al. Continuity of care with doctors — a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open 2018; 8: e021161.
13. Wright M, Hall J, Van Gool K, et al. How common is multiple general practice attendance in Australia? Aust J Gen Pract 2018; 47: 289.
14. Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. BMJ 2017; 356: j84.
15. Maun A, Wessman C, Sundvall PD, et al. Is the quality of primary healthcare services influenced by the healthcare centre’s type of ownership? An observational study of patient perceived quality, prescription rates and follow-up routines in privately and publicly owned primary care centres. BMC Health Serv Res 2015; 15: 417.
16. Warren FC, Abel G, Lyratzopoulos G, et al. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey. BMJ 2015; 350: h2040.
17. Greaves F, Laverty AA, Pape U, et al. Performance of new alternative providers of primary care services in England: an observational study. J R Soc Med 2015; 108: 171–183.
18. Esterman AJ, Fountaine T, McDermott R. Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study. Med J Aust 2016; 204: 23. https://www.mja.com.au/journal/2016/204/1/are-general-practice-characteristics-predictors-good-glycaemic-control-patients
19. Department of Health. Annual Medicare statistics. Canberra: Commonwealth of Australia, 2019. https://www1.health.gov.au/internet/main/publishing.nsf/Content/Medicare%20Statistics-1 (viewed Sept 2019).
20. Australian Institute of Health and Welfare. Health expenditure Australia 2018–19 [Cat. No. HWE 80]. Canberra: AIHW, 2020. https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2018-19/contents/data-visualisation (viewed Oct 2020).
21. Australian Institute of Health and Welfare. Health expenditure Australia 2008–09 [ Cat. No. HWE 51]. Canberra: AIHW, 2010. https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2008-09/contents/table-of-contents (viewed Oct 2020).
22. Moynihan M, Birrell B. GP oversupply — ignoring the evidence. Melbourne: Australian Population Research Institute, Monash University, 2016. http://tapri.org.au/wp-content/uploads/2016/04/GP-oversupply-ignoring-the-evidence-12-Dec-2016.pdf (viewed Sept 2019).
23. Bayram C. Evaluation of pathology ordering by general practitioners in Australia. Sydney: University of Sydney, 2013. https://ses.library.usyd.edu.au/handle/2123/9471 (viewed Oct 2020).
24. Studdert DM, Britt HC, Pan Y, et al. Are rates of pathology test ordering higher in general practices co-located with pathology collection centres? Med J Aust 2010; 193: 114-119. https://www.mja.com.au/journal/2010/193/2/are-rates-pathology-test-ordering-higher-general-practices-co-located-pathology#:~:text=Conclusions%3A%20Pathology%20test%2Dordering%20rates,ordering%20behaviour%20may%20be%20unaffected
25. Whyatt D, Tuson M, Haynes E, et al. Burden of primary care-type emergency department presentations using clinical assessment by general practitioners: a cross-sectional study. Emerg Med Australas 2019; 31: 780–786.

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