The decline in bulk-billing and increase in out-of-pocket costs for general practice consultations in rural areas of Australia, 1995-2001.

摘要: Objective: To describe the changes in bulk-billing and out-of-pocket costs for Australian general practice consultations over period 1995-2001. Design: Retrospective analysis of 1996-2001 survey data from Longitudinal Study on Women's Health (ALSWH), linked with Medicare Department Veterans' Affairs (DVA) 1995 to 2001. Participants: 22 633 women who gave consent linkage their ALSWH Medicare/DVA records. In 1996, "young" cohort (n = 6219) were aged 18-23 years, those "mid-age" 8883) 45-50 "older" 7531) 70-75 years. Outcome measures: Out-of-pocket paid by patients consultations, calendar year, urban/rural area residence, age, frequency attendance, self-rated health, education level. Results: For each age group year studied, use was lower rural areas than urban areas. example, 2000, percentage areas, respectively, had all bulk-billed 31% v 52% (young women), 24% 45% (mid-age women) 58% 79% (older women). There has been a steady decline since 1995. The average cost per consultation higher living After adjusting health socioeconomic factors, more twice as likely have areas: odds ratio (OR), 2.4 (95% Cl, 2.1-2.7) women); OR, 2.5 2.3-2.8) 2.6 2.3-2.9) Conclusions: Australia, geographic differential is widening. Policy are required enable remote access affordable healthcare services.