Changes in size and co-location of health services for Australian general practice, 2000-2016

The study analysed how the proportion of general practitioners (GPs) working in different practice sizes and how co-located health services changed over time in Australia, including the differences in these variables across different geographic and socioeconomic areas.

A secondary analysis of University of Sydney's Bettering the Evaluation and Care of Health dataset, a continuous cross-sectional study of GP activity in Australia, was performed. We analysed changes in practice size; changes in co-location of GP practices with other health services (e.g. physiotherapy, psychology, pathology, imaging); changes in practice nurses employed within GP practices; and changes in GP and practice characteristics (including GP sex, GP age, GP hours worked, and practice after-hours arrangements) from April 2000 to March 2016.

The average practice size increased from 4.6 (95% confidence interval (CI) 4.4-4.9) GPs in 2000-2001 to 7.5 (95% CI 7.2-7.8) GPs in 2015-2016. The proportion of GPs working at practices with co-located health services increased from 66.3% (95% CI 63.4-69.2) in 2008-2009 to 94.0% (95% CI 92.5-95.5) in 2015-2016. The proportion of GPs at practices with practice nurses significantly increased from 60.1% (95% CI 56.9-63.2) in 2004-2005 to 84.7% (95% CI 82.4-87.0) in 2015-2016. There were no significant differences across these variables in different geographic and socioeconomic areas, except for practice nurses.

This research confirms that GP practice size, co-location of health services, and the number of nurses employed within general practices have increased significantly from 2000 to 2016. We suggest that further data sources are required to explore the implications of these findings and to inform policy.