The relationship between having a regular general practitioner (GP) and the experience of healthcare barriers: a cross-sectional study among young people in NSW, Australia, with oversampling from marginalised groups

Melissa Kang,Fiona Robards,Tim Usherwood,Lena Sanci,Georgina Luscombe

doi:10.1186/s12875-020-01294-8

Abstract

BackgroundYoung people (12–24 years) visit general practice but may not have a ‘regular’ general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of healthcare barriers and attitudes to health system navigation among young people in New South Wales (NSW), Australia.MethodsThis study was a cross-sectional survey administered either online or face-to-face in community settings. Young people living in NSW were recruited, with oversampling of those from five socio-culturally marginalised groups (those who were Aboriginal and Torres Strait Islander, homeless, of refugee background, in rural or remote locations, sexuality and/or gender diverse). In this analysis of a larger dataset, we examined associations between having a regular GP, demographic and health status variables, barriers to health care and attitudes to health system navigation, using chi-square tests and odds ratios. Content and thematic analyses were applied to free-text responses to explore young people’s views about having a regular GP.ResultsOne thousand four hundred and sixteen young people completed the survey between 2016 and 2017. Of these, 81.1% had seen a GP in the previous 6 months and 57.8% had a regular GP. Cost was the most frequently cited barrier (45.8%) to accessing health care generally. Those with a regular GP were less likely to cite cost and other structural barriers, feeling judged, and not knowing which service to go to. Having a regular GP was associated with having more positive attitudes to health system navigation. Free-text responses provided qualitative insights, including the importance of building a relationship with one GP.ConclusionsGeneral practice is the appropriate setting for preventive health care and care coordination. Having a regular GP is associated with fewer barriers and more positive attitudes to health system navigation and may provide better engagement with and coordination of care. Strategies are needed to increase the proportion of young people who have a regular GP.

Highlights

Young people (12–24 years) visit general practice but may not have a ‘regular’ general practitioner (GP)
General practice is the appropriate setting for preventive health care and care coordination
Having a regular GP is associated with fewer barriers and more positive attitudes to health system navigation and may provide better engagement with and coordination of care

Summary

Introduction

Young people (12–24 years) visit general practice but may not have a ‘regular’ general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of healthcare barriers and attitudes to health system navigation among young people in New South Wales (NSW), Australia. Continuity of care and care coordination in primary health reduces rates of hospital admissions [1]. General practice is fee-for-service, with most services eligible for rebates from the universal health insurance scheme known as Medicare. GPs choose whether to bill patients or to claim the patient’s rebate directly from Medicare. This latter practice is known as ‘bulk-billing’ and involves no upfront or ‘gap’ fee.

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