MEDICAL CARE IN WESTERN SYDNEY: A REPORT ON THE UTILIZATION OF HEALTH SERVICES BY A DEFINED POPULATION

Abstract

A household survey of a representative sample of the population of five local government areas in western Sydney revealed a high rate of utilization of hospital and medical services. The very old and the very young place the greatest demands on these services, and utilization rates are higher for women than for men. General practitioners form the major source of primary medical, antenatal and obstetric care and undertake a quarter of all surgical operations. Nearly half the admissions to hospital take place in hospitals well beyond the area of residence of the population. This demonstrates clearly the failure of hospital planners to provide sufficient specialized hospital services in a region of rapid growth. Over one-quarter of hospital admissions occur in small private hospitals, in which significantly more general practitioner surgery is performed. Overall, utilization of, and attitudes towards, medical services do not vary with educational or occupational status. However, very definite differences are noted between various ethnic groups. The Australian-born are the most general practitionerorientated, while the British and Northern Europeans tend to expect more specialist attention. A quarter of the Southern Europeans had no health Insurance at the time of the survey, and this group nominated public hospitals as a source of primary medical care more than any other group. With few exceptions, the population appears to be satisfied with the present services and demonstrates considerable faith in its general practitioners. Future planning must consider the central role of the general practitioner, and also cannot afford to ignore the contribution (desirable or otherwise) being made at present by private hospitals.