Rural and Remote Health Journal photo
African section Asian section European section International section Latin American section North American section
home
login/register
current articles
contribute
information for authors
status/user profile
links/forums
about us

Short Communication

Type 2 diabetes, cardiovascular disease and the utilisation of primary care in urban and regional settings

Submitted: 4 May 2011
Revised: 13 September 2011
Published: 7 November 2011

Full text: You can view the full article, or view a printable version.
Comments: (login to access the comments on this article)

Author(s) : Unger CC, Warren N, Canway R, Manderson L, Grigg K.

Carla UngerNarelle WarrenRachel CanwayLenore MandersonKaine Grigg

Citation: Unger CC, Warren N, Canway R, Manderson L, Grigg K.  Type 2 diabetes, cardiovascular disease and the utilisation of primary care in urban and regional settings. Rural and Remote Health (Internet) 2011; 11: 1795. Available: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=1795 (Accessed 19 October 2017)

ABSTRACT

Introduction:  There are marked inequities in access to and use of different primary care providers – including GPs, practice nurses, allied health services and complementary and alternative medicine (CAM) providers among populations residing in different geographical areas of Australia. Little research has focused on patterns of primary care health service utilisation according to locality in relation to the management of serious chronic illness, with even less on the use of CAM. In this article geographic similarities and differences in primary care service usage are examined among people with cardiovascular disease and/or type 2 diabetes mellitus residing in regional and urban Victoria, Australia.
Methods:  Between April and July 2010, hard-copy questionnaires were sent to a random selection of 10 000 registrants from the National Diabetes Services Scheme, 2162 were distributed via Heart Support Australia and community organisations within the state of Victoria; an online version yielded 290 valid responses. This article draws on data from the 2914 returned survey responses in which people provided their residential postal codes. From this information, geographic location was determined on the basis of the Australian Standard Geographical Classification. Data were subject to inferential analyses using PASW Statistics 18.0 (SPSS; Chicago, IL, USA). A series of contingency table analyses were conducted to evaluate the relationship between primary care service use and respondents’ geographical locality. Contingency analyses and χ2 tests were also conducted to examine the differences between rural and metropolitan frequency of GP use.
Results:  In comparison with urban respondents, rural respondents reported greater use of allied health practitioners, district or practice nurses, and community health centres. Conversely, use of hospital outpatient services was significantly higher among metropolitan respondents. Use of GP clinics was not related significantly to respondents’ locality, nor was use of inpatient hospital services or use of counselling, psychiatry or psychology services. Frequency of GP use, however, varied significantly among geographical categorisations, with urban respondents visiting their GPs more frequently.
Conclusions:  While GPs play an important role in chronic disease management in Australia, the rate of GP attendance remains lower among patients living in regional areas. By contrast, the level of patient engagement with nurse practitioners and allied health professionals in this study was significantly higher among rural respondents. Issues related to access appear to play an important role in determining what primary care services people use when managing their chronic conditions and their frequency of consultation.

Key words: Australia, cardiovascular diseases, chronic disease management, diabetes mellitus type 2, health service utilisation, locality, primary health care.

This abstract has been viewed 3942 times since 7-Nov-2011.

   
 

   CONTACT US | COPYRIGHT AND DISCLAIMER | ADMIN ONLY