Primary health care services are often targeted and evaluated along geographical boundaries.
However, pre-existing administrative boundaries may not reflect patterns of existing use of primary health care services and thus may not be suitable for this purpose. This motivates the need for bespoke geographies of self-sufficient primary health care use, where the majority of health services accessed in these geographies are from people living within them. Such geographies are extant in the United States and are known as Primary Care Service Areas (PCSAs). This study is the first time they have been developed in Australia.
The locations of approximately 260,000 patients geocoded to Postal Areas (POA) from the 45- and Up Study in New South Wales was linked to the POA locations of General Practitioners (GPs) patronized by them in Medicare Benefits Scheme data. Patient Postal areas were allocated to PCSAs following a “maximum vote” methodology similar to the one used by Goodman et al in the United States.
A majority (median 55%) obtain their primary healthcare from within their PCSAs. In contrast a minority obtain their primary healthcare from within a POA.
PCSAs are a new and rational geography in Australia at which primary healthcare research and policymaking can be implemented following the lead of the United States. PCSA data will be made freely available for stakeholders and researchers to use.