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 postcode classified as RRMA 5-7.