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Barriers to effective primary health care for adolescents
Author(s) -
Veit Friederike C M,
Sanci Lena A,
Coffey Carolyn M M,
Young Doris Y L,
Bowes Glenn
Publication year - 1996
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1996.tb124885.x
Subject(s) - stratified sampling , medicine , family medicine , curriculum , health care , mental health , nursing , medical education , psychology , psychiatry , pedagogy , pathology , economics , economic growth
Objectives To assess general practitioners' (GPs') perceptions of barriers in the health care system that hinder provision of effective adolescent health care; and to assess the training needs of GPs for a future education program in adolescent health issues. Design Retrospective questionnaire survey. Methods A 66‐item questionnaire was mailed during May and June 1995 to a random stratified sample of 997 rural and urban Victorian GPs. A Practice Assessment Task enabling respondents to fulfil Royal Australian College of General Practitioners' quality assurance requirements was mailed on return of completed questionnaires if requested. Results The response rate was 72.4%. After adjusting for stratified sampling, 7% (95% confidence interval [CI], 73%‐81%) of respondents favoured individual Medicare cards for adolescents from the age of 16. Thirty‐eight per cent (95% CI, 34%‐43%) were less willing to charge for longer consultations because they feared Health Insurance Commission (HIC) investigation. Most respondents indicated that their undergraduate training in adolescent mental health issues was inadequate and 64% (95% CI, 61%‐68%) found it difficult to obtain advice about complex mental health problems. An interest in continuing medical education in adolescent health issues was expressed by 82% (95% CI, 79%‐86%) of respondents. Conclusions Individual Medicare cards should be automatically issued to adolescents from the age of 16 to improve their ability to access health care. Revision of the Medicare rebate system and clarification of HIC's investigative functions may improve GPs' effectiveness in adolescent consultations. Undergraduate medical and GP training should include curriculum relevant to adolescent health care.