Abstract
BackgroundTo develop a method to use survey data to establish catchment areas of primary care or Primary Care Service Areas. Primary Care Service Areas are small areas, the majority of patients resident in which obtain their primary care services from within the geography.MethodsThe data are from a large health survey (n =267,153, year 2006–2009) linked to General Practitioner service use data (year 2002–2010) from New South Wales, Australia. Our methods broadly follow those used previously by researchers in the United States of America and Switzerland, with significant modifications to improve robustness. This algorithm allocates post code areas to Primary Care Service Areas that receive the plurality of patient visits from the post code area.ResultsConsistent with international findings the median Localization Index or the median percentage of patients that obtain their primary care from within a Primary Care Service Area is 55% with localization increasing with rurality.ConclusionsWith the additional methodological refinements in this study, Australian Primary Care Service Areas have great potential to be of value to policymakers and researchers.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-072X-13-38) contains supplementary material, which is available to authorized users.
Highlights
To develop a method to use survey data to establish catchment areas of primary care or Primary Care Service Areas
In the United States [12] and Switzerland [13] where natural catchments of Primary Care (PC) from data on observed flows of patients to PC providers have been built, these geographies have been utilized extensively by researchers [13,14,15]. In this brief report we describe methods to develop natural catchment areas of PC in the state of New South Wales (NSW), Australia using a large survey of people aged 45 and above representing approximately 10% of the people in NSW in that age group
Following Goodman et al.’s version 3 Primary Care Service Area (PCSA) algorithm [20], we identify PCSAs with Localization Index (LI) less than 10 and reassign their constituent Postal Areas (gPOA) to other PCSAs using the usual assignment rules
Summary
Our methods broadly follow those used previously by researchers in the United States of America and Switzerland, with significant modifications to improve robustness This algorithm allocates post code areas to Primary Care Service Areas that receive the plurality of patient visits from the post code area. Flows of patients to and from natural catchments, and the distances associated with these flows could help identify patterns of geographic access, and potentially areas of undersupply of services In spite of these advantages of natural catchment geographies they are not commonly used by policy makers and planners primarily because their construction requires substantial data and technical resources. Census geographies such as Statistical Areas Level 3 which were recently used to report health outcomes and health service usage, while appropriate for reporting census information are not designed for reporting health outcomes or targeting health policies [9]
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