Socioeconomic status of practice location and Australian GP registrars’ training: a cross-sectional analysis

BACKGROUND: Socioeconomic status (SES) is a major determinant of health. In Australia, areas of socioeconomic disadvantage are characterised by complex health needs and inequity in primary health care provision. General Practice (GP) registrars play an important role in addressing workforce needs, including equitable health care provision in areas of greater socioeconomic disadvantage. We aimed to characterize GP registrars’ practice location by level of socioeconomic disadvantage, and establish associations (of registrar, practice, patient characteristics, and registrars’ clinical behaviours) with GP registrars training being undertaken in areas of greater socioeconomic disadvantage. METHODS: A cross-sectional analysis from the Registrars’ Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing, multi-centre, cohort study that documents 60 consecutive consultations by each GP registrar once in each of their three six-monthly training terms. The outcome factor was the practice location’s level of socioeconomic disadvantage, defined using the Index of Relative Socio-economic Disadvantage (SEIFA-IRSD). The odds of being in the lowest quintile was compared to the other four quintiles. Independent variables related to the registrar, patient, practice, and consultation. RESULTS: A total of 1,736 registrars contributed 241,945 consultations. Significant associations of training being in areas of most disadvantage included: the registrar being full-time, being in training term 1, being in the rural training pathway; patients being Aboriginal or Torres Strait Islander, or from a non-English-speaking background; and measures of continuity of care. CONCLUSIONS: Training in areas of greater social disadvantage, as well as addressing community need, may provide GP registrars with richer learning opportunities.