Background
In Australia and internationally, rates of potentially preventable hospitalisations (PPH) are used as a proxy measure of accessibility and effectiveness of primary healthcare. However recent research has questioned the validity of this indicator within an Australian context.
Aim
The aim of the study was to explore the association between general practitioner (GP) service utilisation with PPH at the local government area (LGA) level in Western Australia (WA) and whether PPH is a valid indicator of access to primary healthcare. A secondary aim is to identify priorities for targeted policy interventions.
Methods
GP service utilisation was measured using Medicare claims for GP attendance. PPH was measured using hospitalisation data. Age-standardised rates and multiple linear regressions were used to assess the association of GP service utilisation and PPH. Potential confounders adjusted for included sociodemographic characteristics (gender, Indigenous status, socio-economic disadvantage and geographic remoteness) as well as health needs characteristics (proportion of chronic conditions, composite health risk factor and self-assessed health). Additionally, spatial analysis was undertaken to identify LGAs that had significantly different rates of GP service utilisation/PPH compared to the state rate.
Results
GP service utilisation was positively associated with PPH at the LGA level (p=0.0326). Significant confounders included Aboriginal status and geographic remoteness. Spatial analysis outcomes identified LGAs where there are different GP service utilisation and PPH relationship patterns.
Conclusion
This study found a positive relationship between GP service utilisation and PPH instead of the expected inverse association. The study has also potentially identified priorities for targeted policy interventions.