Equity of a government subsidised exercise referral scheme: a population study

Craike, Melinda and Wiesner, Glen and Enticott, Joanne and Bennie, Jason A. and Biddle, Stuart J. H. (2018) Equity of a government subsidised exercise referral scheme: a population study. Social Science and Medicine, 216. pp. 20-25. ISSN 0277-9536

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Abstract

Background: Health inequities could increase if utilisation of physical activity interventions is lower among socioeconomically disadvantaged groups. We examined associations between area level socioeconomic disadvantage and utilisation of Australian government-subsidised, general practitioner (GP)-referred, accredited exercise physiologist (AEPs) services.

Methods: We conducted a cross-sectional analysis of Australian Medical Benefits Scheme (MBS) data (N=228,771 AEP services) for the 2015–2016 financial year and aggregated publicly available data from several sources. Spearman's correlations examined associations between utilisation of AEP services and arealevel socioeconomic disadvantage, indicated by Index of Relative Socioeconomic Disadvantage (IRSD) decile scores. Lower IRSD scores indicate greater levels of socioeconomic disadvantage.

Results: Significant correlations between IRSD score and study variables were as follows: Out-of-pocket expenses/service (rs=0.52); number of patients/AEP provider (rs=−0.42); number of patients/1000 population (rs=−0.24); AEP services/1000 population (rs=−0.18); average services/patient (rs=0.24); and AEP provider/1000 population (rs=0.14).

Conclusion: Patients living in areas of greater disadvantage utilised government-subsidised, GP-referred AEP services at a higher rate and paid lower out-of-pocket fees than those living in more affluent areas. Thus, AEP services are equitably distributed, from a utilisation perspective, and acceptable to patients living in areas of disadvantage. However, the higher caseloads and lower fees that characterise AEP services in areas of greater disadvantage may result in shorter consultation times. Further research on exercise referral schemes is warranted, particularly whether socioeconomic disadvantage is associated with adherence to exercise sessions and health outcomes.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Accepted version made available in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Historic - Institute for Resilient Regions - Centre for Health, Informatics and Economic Research (1 Aug 2018 - 31 Mar 2020)
Faculty/School / Institute/Centre: Historic - Institute for Resilient Regions - Centre for Health, Informatics and Economic Research (1 Aug 2018 - 31 Mar 2020)
Date Deposited: 27 Nov 2019 06:05
Last Modified: 10 Mar 2020 01:57
Uncontrolled Keywords: physical activity; access; health care; referral; exercise physiologist; socioeconomic disadvantage; general practitioner
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Socio-Economic Objectives (2008): C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified
Identification Number or DOI: https://doi.org/10.1016/j.socscimed.2018.09.023
URI: http://eprints.usq.edu.au/id/eprint/36647

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