The prevalence and associations of Australian early-career general practitioners' provision of after-hours care

Allison Turnock; Alison Fielding; Dominica Moad; Amanda Tapley; Andrew Davey; Elizabeth Holliday; Jean Ball; Michael Bentley; Kristen FitzGerald; Catherine Kirby; Neil Spike; Mieke L van Driel; Parker Magin

doi:10.1111/ajr.13022

The prevalence and associations of Australian early-career general practitioners' provision of after-hours care

Aust J Rural Health. 2023 Oct;31(5):906-913. doi: 10.1111/ajr.13022. Epub 2023 Jul 24.

Authors

Allison Turnock^{1

2}, Alison Fielding^{3

4}, Dominica Moad^{3

4}, Amanda Tapley^{3

4}, Andrew Davey^{3

4}, Elizabeth Holliday⁴, Jean Ball⁵, Michael Bentley⁶, Kristen FitzGerald^{1

6}, Catherine Kirby⁷, Neil Spike^{7

8

9}, Mieke L van Driel¹⁰, Parker Magin^{3

4}

Affiliations

¹ University of Tasmania, School of Medicine, Hobart, Tasmania, Australia.
² Department of Health, Hobart, Tasmania, Australia.
³ GP Synergy, NSW & ACT Research and Evaluation Unit, Mayfield West, New South Wales, Australia.
⁴ The University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, New South Wales, Australia.
⁵ Hunter Medical Research Institute (HMRI), Clinical Research Design and Statistical Support Unit (CReDITSS), New Lambton Heights, New South Wales, Australia.
⁶ General Practice Training Tasmania (GPTT), Hobart, Tasmania, Australia.
⁷ Eastern Victoria General Practice Training (EVGPT), Hawthorn, Victoria, Australia.
⁸ Monash University, School of Rural Health, Churchill, Victoria, Australia.
⁹ Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Victoria, Australia.
¹⁰ Faculty of Medicine, General Practice Clinical Unit, The University of Queensland, Brisbane, Queensland, Australia.

PMID: 37488936
DOI: 10.1111/ajr.13022

Abstract

Introduction: Access to after-hours care (AHC) is an important aspect of general practice service provision.

Objective: To establish the prevalence and associations of early-career GPs' provision of AHC.

Design: An analysis of data from the New alumni Experiences of Training and independent Unsupervised Practice (NEXT-UP) cross-sectional questionnaire-based study. Participants were early-career GPs (6-month to 2-year post-Fellowship) following the completion of GP vocational training in NSW, the ACT, Victoria or Tasmania. The outcome factor was 'current provision of after-hours care'. Associations of the outcome were established using multivariable logistic regression.

Findings: Three hundred and fifty-four early-career GPs participated (response rate 28%). Of these, 322 had responses available for analysis of currently performing AHC. Of these observations, 128 (40%) reported current provision of AHC (55% of rural participants and 32% of urban participants). On multivariable analysis, participants who provided any AHC during training were more likely to be providing AHC (odds ratio (OR) 5.51, [95% confidence interval (CI) 2.80-10.80], p < 0.001). Current rural location and in-training rural experience were strongly associated with currently providing AHC in univariable but not multivariable analysis.

Discussion: Early-career GPs who provided AHC during training, compared with those who did not, were more than five times more likely to provide after-hours care in their first 2 years after gaining Fellowship, suggesting participation in AHC during training may have a role in preparing registrars to provide AHC as independent practitioners.

Conclusion: These findings may inform future GP vocational training policy and practice concerning registrars' provision of AHC during training.

Keywords: after-hours care; education, medical, graduate; family practice; physicians, primary care; rural health.

MeSH terms

After-Hours Care*
Australia
Cross-Sectional Studies
General Practice* / education
General Practitioners*
Humans
Prevalence

Grants and funding

Royal Australian College of General Practitioners