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The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?


Neil, AL and Nelson, M and Palmer, AJ, The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?, Health Policy, 120, (7) pp. 809-817. ISSN 0168-8510 (2016) [Refereed Article]


Copyright Statement

2016 The Authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

DOI: doi:10.1016/j.healthpol.2016.05.005


In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored.

Item Details

Item Type:Refereed Article
Keywords:After-hours care, Australian health system, Equity, Health care reform, Incentive, Reimbursement, Rural health services
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Neil, AL (Associate Professor Amanda Neil)
UTAS Author:Nelson, M (Professor Mark Nelson)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:110115
Year Published:2016
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-07-13
Last Modified:2022-08-29
Downloads:91 View Download Statistics

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