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Financial costs for teaching in rural and urban Australian general practices: is there a difference?
Caroline O Laurence1, Maryanne Coombs, Janice Bell
1Adelaide to Outback GP Training Program, North Adelaide; Discipline of General Practice, University of Adelaide, Adelaide, South Australia.
Objective:
To determine if the financial costs of teaching GP registrars differs between rural and urban practices.
Design:
Cost-benefit analysis of teaching activities in private GP for GP vocational training. Data were obtained from a survey of general practitioners in South Australia and Western Australia.
Setting And Participants:
General practitioners and practices teaching in association with the Adelaide to Outback General Practice Training Program or the Western Australian General Practice Training.
Main Outcome Measures:
Net financial effect per week per practice.
Results:
At all the training levels, rural practices experienced a financial loss for teaching GP registrars, while urban practices made a small financial gain. The differences in net benefit between rural and urban teaching practices was significant at the GPT2/PRRT2 (-$515 per week 95% CI -$1578, -$266) and GPT3/PRRT3 training levels (-$396 per week, 95% CI (-$2568, -$175). The variables contributing greatest to the difference were the higher infrastructure costs for a rural practice and higher income to the practice from the GP registrars in urban practices.
Conclusion:
There were significant differences in the financial costs and benefits for a teaching rural practice compared with an urban teaching practice. With infrastructure costs which include accommodation, being a key contributor to the difference found, it might be time to review the level of incentives paid to practices in this area. If not addressed, this cost difference might be a disincentive for rural practices to participate in teaching.
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