Did general practice health assessments of older Australians improve equity?

Abstract

Objective: To examine if claims for general practice health assessments of older persons in Australia over the period 1 November 1999 to 30 September 2002 were equitably distributed. Design: Closed cohort study with data analysis using logistic regression. Setting: Private general practice in Australia. Participants: All Australians aged 75 or more years at 1 October 1999, who were eligible to claim for a health assessment. Measures studied: Medicare and Department of Veterans? Affairs (DVA) medical claims data, and personal characteristics of claimants: age, sex, DVA beneficiary status, rurality and socio-economic status of postcode of residence. Rurality was classified by the Rural Remote and Metropolitan Area Classification (RRMA) and socio-economic status by the Index of Relative Socio-economic Deprivation (IRSD) for the postcode. Results: The cohort initially contained 886 185 subjects. Over the 35 months, 271 939 individuals (31%) claimed at least one health assessment. Those most likely to have claimed for a health assessment were aged 80 to 84 years, female, entitled to treatment under DVA arrangements, lived in postcodes classified as RRMA 1?4 and classified as the most disadvantaged IRSD quartile. Conclusion: Over this period, general practice health assessments appear to have been equitably distributed except for those living in postcodes classified as RRMA 5?7.