Patient affiliation with GPs in Australia-Who is and who is not and does it matter?

Aims and rationale: Recent government reports have proposed voluntary enrolment with general practitioners for certain groups of patients to enhance their continuity of care.We examine which groups of patients are presently "de facto" affiliated with GPs, and whether affiliated patients are more likely to receive advice from their GPs on primary preventative matters such as weight, exercise and smoking. Methods: A nationally representative cross sectional survey of Australian residents aged 18 years or over was conducted via telephone in 2008. Data from 1146 participants were analysed in both tabular forms and with logistic regression. Findings: Most Australian adults are affiliated, de facto, with an individual GP or a GP practice (11% often go to different GPs). Factors associated with affiliation were patient age, education, satisfaction with their GP and urban or rural location. Patients with poor or fair self assessed health are relatively unlikely to be affiliated with a GP. Weak support was found for the hypothesis that affiliated patients were more likely to receive primary preventative advice on weight and diet and no support found in relation to exercise, smoking or alcohol consumption. Benefits to the community: The study suggests policy on voluntary patient enrolment should focus on providing continuity of care to those with poor health. If further studies confirm affiliation does not enhance preventive health advice, further policy interventions may be appropriate.