McRae, I, Van Gool, K, Hall, J, Yen, L & Wright, M 2019, 'Failure to access prescribed pharmaceuticals by older patients with chronic conditions', Australian Health Review.View/Download from: Publisher's site
Wright, MC & Mainous, A 2018, 'Can continuity of care in primary care be sustained?', Australian Journal for General Practitioners, vol. 47, pp. 667-669.
Wright, MC 2018, 'Continuity of care is in the eye of the beholder', Australian Journal for General Practitioners, vol. 47, pp. 661-661.
Wright, M & Mainous, AG 2018, 'Can continuity of care in primary care be sustained in the modern health system?', Australian Journal of General Practice, vol. 47, no. 10, pp. 667-669.View/Download from: UTS OPUS
Wright, MC, Hall, J, Van Gool, K & Haas, M 2018, 'How common is multiple general practice attendance in Australia?', Australian Journal of General Practice, vol. 47, no. 5, pp. 289-296.View/Download from: UTS OPUS
Background and objectives
Australians can seek general practice care from multiple general practitioners (GPs) in multiple locations. This provides high levels of patient choice but may reduce continuity of care. The aim of this study was to estimate the prevalence of attendance at multiple general practices in Australia, and identify patient characteristics associated with multiple practice attendances.
A cross-sectional survey of 2477 Australian adults was conducted online in July 2013. Respondents reported whether they had attended more than one general practice in the past year, and whether they had a usual general practice and GP. Demographic information, health service use and practice characteristics were also obtained from the survey.
Over one-quarter of the sample reported attending more than one practice in the previous year. Multiple practice attendance is less common with increasing age, and less likely for survey respondents from regional Australia, compared with respondents from metropolitan areas. Multiple practice attenders are just as likely as single practice attenders to have a usual GP. Discussion
A significant proportion of general practice care is delivered away from usual practices. This may have implications for health policy, in terms of continuity and quality of primary care.
Taylor, CJ, Wright, MC, Jackson, CL & Hobbs, R 2016, 'Grass is Greener? General practice in England and Australia', British Journal of General Practice, vol. 66, no. 649, pp. 428-429.View/Download from: Publisher's site
Tan, S, Erens, B, Wright, M & Mays, N 2015, 'Patients' experiences of the choice of GP practice pilot, 2012/2013: a mixed methods evaluation.', BMJ open, vol. 5, no. 2, p. e006090.View/Download from: Publisher's site
OBJECTIVES:To investigate patients' experiences of the choice of general practitioner (GP) practice pilot. DESIGN:Mixed-method, cross-sectional study. SETTING:Patients in the UK National Health Service (NHS) register with a general practice responsible for their primary medical care and practices set geographic boundaries. In 2012/2013, 43 volunteer general practices in four English NHS primary care trusts (PCTs) piloted a scheme allowing patients living outside practice boundaries to register as an out of area patient or be seen as a day patient. PARTICIPANTS:Analysis of routine data for 1108 out of area registered patients and 250 day patients; postal survey of out of area registered (315/886, 36%) and day (64/188, 34%) patients over 18years of age, with a UK mailing address; comparison with General Practice Patient Survey (GPPS); semistructured interviews with 24 pilot patients. RESULTS:Pilot patients were younger and more likely to be working than non-pilot patients at the same practices and reported generally more or at least as positive experiences than patients registered at the same practices, practices in the same PCT and nationally, despite belonging to subgroups of the population who typically report poorer than average experiences. Out of area patients who joined a pilot practice did so: after moving house and not wanting to change practice (26.2%); for convenience (32.6%); as newcomers to an area who selected a practice although they lived outside its boundary (23.6%); because of dissatisfaction with their previous practice (13.9%). Day patients attended primarily on grounds of convenience (68.8%); 51.6% of the day patient visits were for acute infections, most commonly upper respiratory infections (20.4%). Sixty-six per cent of day patients received a prescription during their visit. CONCLUSIONS:Though the 12-month pilot was too brief to identify all costs and benefits, the scheme provided a positive experience for participating patients and practi...
Wright, MC 2015, 'Is there value in the Relative Value Study? Caution before Australian Medicare reform', Medical Journal of Australia, vol. 203, no. 8, pp. 331-334.View/Download from: Publisher's site
Perkins, N, Coleman, A, Wright, M, Gadsby, E, McDermott, I, Petsoulas, C & Checkland, K 2014, 'The 'added value' GPs bring to commissioning: a qualitative study in primary care', BRITISH JOURNAL OF GENERAL PRACTICE, vol. 64, no. 628, pp. E728-E734.View/Download from: Publisher's site
Mays, N, Tan, S, Eastmure, E, Erens, B, Lagarde, M & Wright, M 2014, 'Potential impact of removing general practice boundaries in England: a policy analysis.', Health policy (Amsterdam, Netherlands), vol. 118, no. 3, pp. 273-278.View/Download from: Publisher's site
In 2015, the UK government plans to widen patient choice of general practitioner (GP) to improve access through the voluntary removal of practice boundaries in the English NHS. This follows a 12-month pilot in four areas where volunteer GP practices accepted patients from outside their boundaries. Using evidence from the pilot evaluation, we discuss the likely impact of this policy change on patient experience, responsiveness and equity of access. Patients reported positive experiences but in a brief pilot in four areas, it was not possible to assess potential demand, the impact on quality of care or health outcomes. In the rollout, policymakers and commissioners will need to balance the access needs of local residents against the demands of those coming into the area. The rollout should include full information for prospective patients; monitoring and understanding patterns of patient movement between practices and impact on practice capacity; and ensuring the timely transfer of clinical information between providers. This policy has the potential to improve choice and convenience for a sub-group of the population at lower marginal costs than new provision. However, there are simpler, less costly, ways of improving convenience, such as extending opening hours or offering alternatives to face-to-face consultation.
Wright, MC 2012, 'Pay-for-performance programs: do they improve the quality of primary care?', Australian family physician, vol. 41, no. 12, pp. 989-991.
The recent release of The Royal Australian College of General Practitioners clinical quality indicators has sparked renewed debate about the role of pay-for-performance (P4P) programs and their potential usefulness in Australian general practice. Objective: This article seeks to update recent evidence about the impact of P4P programs on the quality of primary care and presents the evidence based viewpoint that there are potential problems with P4P, which may limit its usefulness. Discussion: P4P programs are attractive to funders as they suggest a theoretical link between provider performance and improvements in healthcare quality - and potentially improved control over costs. Although P4P programs in primary care appear to have an effect on the behaviour of general practitioners, there is little evidence that these programs in their current form improve health outcomes or healthcare system quality. Further research is needed into the effect of these programs on healthcare quality before they are introduced into Australian general practice.
Wright, MC 2018, 'Health system and funding reform – what do we know that works?', Australian Physiotherapists Assocation 2018 Conference, Hobart.
Wright, MC, Hall, J, Haas, M, Van Gool, K & Yu, S 2018, 'The relationship between continuity of care and cervical cancer screening', 40th Annual Australian Health Economics Society Conference, Hobart.
Wright, MC 2016, 'Changing continuity of care in Australian General Practice', 38th Annual Australian Health Economics Society Conference, Perth.
Wright, MC 2016, 'From Provider Continuity to Practice Integration. Changing Care in Australian General Practice', 16th International Conference for Integrated Care, Barcelona, Spain.
Wright, MC 1970, 'Who uses more than one general practice?', Primary Health Care Research Conference, Adelaide.
Wright, MC 1970, 'Discontinuity in Australian general practice', iHEA, 11th World Congress on Health Economics, Milan, Italy.